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Int. J. Environ. Res. Public Health 2017, 14(5), 472; doi:10.3390/ijerph14050472

Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh

1
Department of Population Family and Reproductive health, International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
2
Department of International Health, International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
3
Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
4
Centre for Injury Prevention and Research, Dhaka 1206, Bangladesh
*
Author to whom correspondence should be addressed.
Academic Editor: Ulf-G. Gerdtham
Received: 6 February 2017 / Revised: 7 April 2017 / Accepted: 21 April 2017 / Published: 29 April 2017
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Abstract

This study provides a comprehensive review of the care-seeking patterns and direct economic burden of injuries from the victims’ perspective in rural Bangladesh using a 2013 household survey covering 1.17 million people. Descriptive statistics and bivariate analyses were used to derive rates and test the association between variables. An analytic model was used to estimate total injury out-of-pocket (OOP) payments and a multivariate probit regression model assessed the relationship between financial distress and injury type. Results show non-fatal injuries occur to 1 in 5 people in our sample per year. With average household size of 4.5 in Bangladesh--every household has an injury every year. Most non-fatally injured patients sought healthcare from drug sellers. Less than half of fatal injuries sought healthcare and half of those with care were hospitalized. Average OOP payments varied significantly (range: $8–$830) by injury type and outcome (fatal vs. non-fatal). Total injury OOP expenditure was $355,795 and $5000 for non-fatal and fatal injuries, respectively, per 100,000 people. The majority of household heads with injuries reported financial distress. This study can inform injury prevention advocates on disparities in healthcare usage, OOP costs and financial distress. Reallocation of resources to the most at risk populations can accelerate reduction of preventable injuries and prevent injury related catastrophic payments and impoverishment. View Full-Text
Keywords: injuries; cost; out-of-pocket; economic burden; care-seeking patterns; low-and-middle-income countries; Bangladesh injuries; cost; out-of-pocket; economic burden; care-seeking patterns; low-and-middle-income countries; Bangladesh
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Alfonso, Y.N.; Alonge, O.; Hoque, D.M.E.; Ul Baset, M.K.; Hyder, A.A.; Bishai, D. Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh. Int. J. Environ. Res. Public Health 2017, 14, 472.

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