Indian Journal of Burns

COMMENTARY
Year
: 2012  |  Volume : 20  |  Issue : 1  |  Page : 53--54

Analyzing the socio-economic cost of burn care


Divya Narain Upadhyaya, Vaibhav Khanna 
 Department of Plastic Surgery, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Correspondence Address:
Divya Narain Upadhyaya
B-2/128, Sector - F, Janakipuram, Lucknow 226 021
India




How to cite this article:
Upadhyaya DN, Khanna V. Analyzing the socio-economic cost of burn care.Indian J Burns 2012;20:53-54


How to cite this URL:
Upadhyaya DN, Khanna V. Analyzing the socio-economic cost of burn care. Indian J Burns [serial online] 2012 [cited 2022 Jan 25 ];20:53-54
Available from: https://www.ijburns.com/text.asp?2012/20/1/53/111785


Full Text

Burns cause morbidities which not only are limited merely to the physical health of the patient but also have social, economic, and psychological ramifications. Treatment of burns is prolonged, often requiring staged surgeries, intensive nursing care, and prolonged rehabilitative support. Understandably, burn care is known to be among the most costly areas of healthcare. [1] However, few authors all over the world have invested time in elucidating the socio-economic burden of burn care. [2],[3] The largest such study has been done by Sanchez and others where the authors have analyzed the data of 898 patients in 2003 collected through hospital records as well as by patient questionnaires. The study brought up some amazing results; the mean annual cost per burn patient according to this study was USD 99,773 of which direct healthcare costs comprised only 19.6%. [3] The total annual cost for burn care in Spain as reported by these investigators was a staggering USD 313 million.

Socio-economic cost calculation consists of social and economic components. The social cost can be calculated by using an appropriately designed Health Related Quality of Life Score (HRQOL) which should include the patient's perception of his/her disability and the physical and psychological impediment caused due to the burn. Economic burden can be divided into direct and indirect costs. Indirect costs consist of calculation of monetary loss due to work loss, temporary, and permanent disability and/or death. Direct costs can again be health-related or nonhealthcare costs. Direct healthcare costs include cost of hospitalization, surgeries, intensive care, nursing, and drug/disposable costs. Direct nonhealthcare costs cover the economic burden of maintaining/rehabilitating the burn patient into his or her daily life and include performance of professional tasks (for example by a physiotherapist) as well as those performed by lay persons/family members. [3] Most of the developed countries have healthcare systems where the costs are borne either by the government or health insurance providers. This makes burn care feasible for the patient which otherwise would be unbearable for the individual, as is the case in India.

In the present study the economic burden of burn care per patient (in a municipal hospital with subsidized fares) has been found by the investigators to be in the range of USD 690-1153. This study examines a very important aspect of burn care which has hitherto been largely untouched. It is, however, severely limited in the areas of sample size and study design. If any logical and reliable conclusions have to be drawn from such an exercise, the scope of the investigation has to be expanded and the sample size increased several fold.

Another study worth mentioning is by S. R. Mashreky and others [4] where the authors have examined the records of 791 burn patients admitted to 16 district hospitals and 45 upazila health centers (district subunits) in Bangladesh. The authors found burn injuries to constitute 2% of all injury admissions over a period of 1 year. These patients had the longest hospital stay and the highest management costs of all the admissions during that period. Such prohibitive costs preclude effective and efficient management of burn injuries especially in developing or underdeveloped nations where health care cost is not borne by either the state or health insurance providers. An effective burn prevention program is thus the best option for circumventing the enormous socio-economic impact of burn injuries in these countries. These costs, which are almost always borne by the patients and their family, cause a heavy damage to the fragile socio-economic balance of these families, the impact of which is at least difficult, if not impossible, to measure at the moment. Large burn centers admitting and managing burn patients have to take the initiative in assessing the cost of burn care in India along with suitable help from the state machinery/nongovernmental organizations. Compulsory reporting of burn injuries and establishment of a central burn registry shall go a long way in assessment of the status of burn care in India and in formulating effective policies for its prevention.

References

1Torrati FG, Rossi LA, Ferreira E, Dalri MC, de Carvalho EC, dos Santos Barbeira CB. Analysis of cost of dressings in the care of burn patients. Burns 2000;26:289-93.
2Eldad A, Stern Z, Sover H, Neuman R, Ben Meir P, Wexler MR. The cost of an extensive burn survival. Burns 1993;19:235-8.
3Alfonso Sanchez JL, Bastida JL, Martinez MM, Martin Moreno JM, Chamorro JJ. Socio-economic cost and health-related quality of life of burn victims in Spain. Burns 2008;34:975-81.
4Mashreky SR, Rahman A, Chowdhury SM, Giashuddin S, Svanstrom S, Khan TF, et al. Burn injury: Economic and social impact on a family. Public Health 2008;122:1418-24.