TY - JOUR
T1 - Implications of patient-borne costs associated with pediatric neurosurgical care in eastern Africa
AU - Awori, Jonathan
AU - Strahle, Jennifer
AU - Okechi, Humphrey
AU - Davis, Matthew C.
N1 - Publisher Copyright:
© 2016 AANS.
PY - 2016/7
Y1 - 2016/7
N2 - Objective: Pediatric neurosurgery can be highly cost-effective even in the developing world, but delivery of these services is hampered by resource limitations at the levels of both health care infrastructure and individual patients. Few studies have evaluated costs borne by neurosurgical patients in the developing world and their potential implications for efficient and effective delivery of care in this population. Methods: The families of 40 pediatric neurosurgery patients were surveyed in February 2015 at the AIC Kijabe Hospital in Kijabe, Kenya. Costs associated with obtaining inpatient care were assessed. Results: Patient families were charged an average of US $539.44 for neurosurgical services, representing 132% of their annual income. Indirect expenses (transport, food and lodging, lost wages) constituted US $79.37, representing 14.7% of the overall cost and 19.5% of their annual income. Conclusions: Expansion of pediatric neurosurgical services throughout the developing world necessitates increased attention to seemingly insignificant expenses that are absorbed by patients and their families. Even when all direct costs are covered at the institutional or national level, without additional assistance, some patients may be too poor to obtain even "free" neurosurgical care.
AB - Objective: Pediatric neurosurgery can be highly cost-effective even in the developing world, but delivery of these services is hampered by resource limitations at the levels of both health care infrastructure and individual patients. Few studies have evaluated costs borne by neurosurgical patients in the developing world and their potential implications for efficient and effective delivery of care in this population. Methods: The families of 40 pediatric neurosurgery patients were surveyed in February 2015 at the AIC Kijabe Hospital in Kijabe, Kenya. Costs associated with obtaining inpatient care were assessed. Results: Patient families were charged an average of US $539.44 for neurosurgical services, representing 132% of their annual income. Indirect expenses (transport, food and lodging, lost wages) constituted US $79.37, representing 14.7% of the overall cost and 19.5% of their annual income. Conclusions: Expansion of pediatric neurosurgical services throughout the developing world necessitates increased attention to seemingly insignificant expenses that are absorbed by patients and their families. Even when all direct costs are covered at the institutional or national level, without additional assistance, some patients may be too poor to obtain even "free" neurosurgical care.
KW - Global health
KW - Pediatric neurosurgery
KW - Socioeconomic
UR - http://www.scopus.com/inward/record.url?scp=84978934463&partnerID=8YFLogxK
U2 - 10.3171/2015.11.PEDS15445
DO - 10.3171/2015.11.PEDS15445
M3 - Article
C2 - 26966883
AN - SCOPUS:84978934463
SN - 1933-0707
VL - 18
SP - 116
EP - 124
JO - Journal of Neurosurgery: Pediatrics
JF - Journal of Neurosurgery: Pediatrics
IS - 1
ER -