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Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 20532

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Special Issue Editors

Prof. Dr. Abdulgafoor M. Bachani

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Guest Editor

Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
Interests: injury prevention; health systems; health economics
Special Issues, Collections and Topics in MDPI journals

Dr. Jagnoor Jagnoor

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Guest Editor

The George Institute for Global Health, University of New South Wales, Newton, NSW 2042, Australia
Interests: injuries; health systems research and policy research; global health
Special Issues, Collections and Topics in MDPI journals

Dr. Margaret Peden

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Guest Editor

Head of the Global Injury Programme, Senior Research Fellow, University of Oxford Conjoint Senior Lecturer, University of New South Wales, Sydney Co-Director of the WHO Collaborating Centre on Injury Prevention and Trauma Care, UK
Interests: Injury prevention; policy; advocacy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Injuries can lead to long-term functional impairment, reduced health-related quality of life, catastrophic health expenditure, and have social and economic impact. Our understanding of global injury mortality has grown over the past two decades. More substantial but less well documented are non-fatal injuries which lead to hospitalisation, disability, and other long-term consequences in function and the quality of life. It is important to obtain greater insight into the health-related quality of life (HRQoL) of injury patients in order to document people's pathways to recovery and to quantify the impact of injury on population health over time.

Furthermore, trauma and injuries often contribute to catastrophic health expenditure. In recent years, many countries have moved toward universal health coverage, however, health financial protection schemes and compensations systems need to be evaluated to truly understand the economic impact of injuries.

In light of these considerations, this Special Issue aims to publish original articles and comprehensive reviews on the relationship between quality of life and economic impact.

Dr. Jagnoor Jagnoor
Dr. Margaret Peden
Dr. Abdulgafoor M. Bachani
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

trauma
injured
health-related quality of life (HRQL)
HRQoL theoretical models
functioning
patient relevant outcomes
HRQoL assessment
economic impact

Published Papers (6 papers)

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Research

16 pages, 895 KiB

Open AccessArticle

Convergent and Discriminant Validity of the Barthel Index and the EQ-5D-3L When Used on Older People in a Rehabilitation Setting

by Billingsley Kaambwa, Norma B. Bulamu, Christine Mpundu-Kaambwa and Raymond Oppong

Int. J. Environ. Res. Public Health 2021, 18(19), 10314; https://doi.org/10.3390/ijerph181910314 - 30 Sep 2021

Cited by 11 | Viewed by 2137

Abstract

This study compares the empirical performance of a commonly used functional-status measure, the Barthel Index (BI), to that of a widely used generic preference-based instrument, the EuroQoL-5-Dimensions 3 Level (EQ-5D-3L), in older people. Data from older people receiving rehabilitation services were used to test the validity of the BI and EQ-5D-3L. Convergent validity was investigated using Spearman’s correlation, exploratory factor analysis (EFA), scatter plots, Krippendorff’s alpha and modified Bland-Altman plots. Discriminant validity was examined using Kruskal Wallis tests, ceiling effects and EFA. A total of 1690 participants were included in the analysis. The BI total and EQ-5D-3L utility scores showed moderate correlation (r = 0.51; Krippendorff’s alpha = 0.52). Kendall’s Tau-B correlations between BI items and EQ-5D-3L dimensions measuring the same construct were weak to moderate (0.05 ≤ absolute r ≤ 0.54). In the EFA, some BI items cross-loaded onto the same factors as EQ-5D-3L dimensions, suggesting that the instruments were interrelated. The BI, however, focuses more on physical functioning, while the EQ-5D-3L measures broader wellbeing concepts. Both instruments showed good discriminant validity and would therefore be equally valuable for measuring subgroup differences. Researchers should consider using the BI in rehabilitation to capture more physical functioning-specific constructs not measured by the EQ-5D-3L. Full article

(This article belongs to the Special Issue Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries)

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11 pages, 533 KiB

Open AccessArticle

Challenges in Documenting Non-Fatal Drowning Disability in Bangladesh: A Community-Based Survey

by Jagnoor Jagnoor, Medhavi Gupta, Aliki Christou, Rebecca Q. Ivers, Soumyadeep Bhaumik, Kamran Ul Baset, Kris Rogers and Aminur Rahman

Int. J. Environ. Res. Public Health 2021, 18(18), 9738; https://doi.org/10.3390/ijerph18189738 - 15 Sep 2021

Viewed by 2231

Abstract

Limited access to health care and the lack of robust data systems means non-fatal drownings are largely missed in low-and middle-income countries. We report morbidity among individuals who experienced non-fatal drowning in the Barishal Division, Bangladesh. A representative household survey was conducted in the Barishal Division in southern Bangladesh between September 2016 and February 2017, covering a population of 386,016. The burden of non-fatal drowning was assessed using the WHODAS 2.0 disability assessment tool, a generic assessment instrument for health and disability. A total of 5164 non-fatal drowning events occurred in the one year preceding the survey. Among these 18% were multiple events. From these, 4235 people were administered the WHODAS 2.0 questionnaire. Non-fatal drowning incidence rates were highest in children aged 1–4 years at 5810 per 100,000 population, and among males. Non-fatal drowning was associated with lower socio-economic status and larger family sizes. Few respondents (6.5%; 95% CI: 4.5–8.4%) reported some level of disability (WHODAS-12 score > 8). Incidence of non-fatal drowning is high in the population, however limited impact on morbidity was found. There is a need to develop tools and methodologies for reliable and comparable data for non-fatal drowning, especially to capture post-event disability in children. Full article

(This article belongs to the Special Issue Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries)

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13 pages, 351 KiB

Open AccessArticle

Quality of Life and Activities of Daily Living among Patients with Complete Cervical Spinal Cord Injury and Surgical Treatment in Vietnam

by Nguyen Le Bao Tien, Vo Van Thanh, Khuc Thi Hong Hanh, Pham Gia Anh, Le Thi Minh Huyen, Ngo Thanh Tu, Dang Thi Ngoc Mai and Phung Lam Toi

Int. J. Environ. Res. Public Health 2021, 18(18), 9703; https://doi.org/10.3390/ijerph18189703 - 15 Sep 2021

Cited by 2 | Viewed by 2314

Abstract

Spinal cord injury (SCI) is defined as temporary or permanent changes in spinal cord function and reflex activity. The objective of this study is to evaluate health-related quality of life (HRQoL) and activities of daily living (ADL) among postoperative surgery patients with complete cervical SCI in Vietnam and to explore the factors associated with these indices. A cross-sectional study was conducted on 88 adults in Vietnam from June 2018 to June 2019. The EQ-5D-5L, ADL, and instrumental activities of daily living (IADL) were applied. Multivariate Tobit regression was adopted to determine factors that were associated with HRQOL, ADL, and IADL. Results: Participants who were in American Spinal Cord Injury Association (ASIA) scale group A (ASIA-A) had the lowest ADL, IADL index, and HRQOL score (p < 0.001). HRQoL and ADL were affected by health insurance coverage, occupation, type of fracture, and IADL. Meanwhile, IADL was significantly associated with living areas and ASIA. Low HRQoL among patients suffering from SCI was observed. Attention should be given to outcomes related to a disability during clinical treatment and should be treated effectively in the recovery. Full article

(This article belongs to the Special Issue Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries)

15 pages, 372 KiB

Open AccessArticle

Patient Perspectives on Key Outcomes for Vocational Rehabilitation Interventions Following Traumatic Injury

by Kay Bridger, Blerina Kellezi, Denise Kendrick, Kate Radford, Stephen Timmons, Mike Rennoldson, Trevor Jones, Jade Kettlewell and on behalf of the ROWTATE Team

Int. J. Environ. Res. Public Health 2021, 18(4), 2035; https://doi.org/10.3390/ijerph18042035 - 19 Feb 2021

Cited by 6 | Viewed by 4155

Abstract

Returning to work after traumatic injury can have a range of benefits, but there is currently little research that incorporates patient perspectives to identify outcomes of vocational rehabilitation interventions that are important to survivors. Trauma survivors (n = 17) participated in in-depth semi-structured interviews or focus groups exploring outcomes that were important to them for recovery and return to work. Data were analysed using thematic analysis. Participants identified a range of outcomes that they considered important and necessary to facilitate a successful and sustainable return to work: physical and psychological recovery, purposeful life engagement, managing expectations of recovery, managing expectations about return to work, and employers’ expectations. Our participants advocated for a multifaceted and biopsychosocial understanding of recovery and outcomes that need to be captured for vocational rehabilitation interventions. Implications for practice and research are discussed, and recommendations are given based on the findings. Full article

(This article belongs to the Special Issue Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries)

21 pages, 1600 KiB

Open AccessArticle

Prognostic Role of Demographic, Injury and Claim Factors in Disabling Pain and Mental Health Conditions 12 Months after Compensable Injury

by Thi L. Nguyen, Katharine S. Baker, Liane Ioannou, Behrooz Hassani-Mahmooei, Stephen J. Gibson, Alex Collie, Jennie Ponsford, Peter A. Cameron, Belinda J. Gabbe and Melita J. Giummarra

Int. J. Environ. Res. Public Health 2020, 17(19), 7320; https://doi.org/10.3390/ijerph17197320 - 07 Oct 2020

Cited by 3 | Viewed by 2203

Abstract

Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3–6 months post-injury, persistent work disability and opioid use at 6–12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3–6 months, work disability and psychotropic medications at 6–12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed. Full article

(This article belongs to the Special Issue Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries)

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13 pages, 361 KiB

Open AccessArticle

Economic Burden of Road Traffic Injuries in Nepal

by Amrit Banstola, Jesse Kigozi, Pelham Barton and Julie Mytton

Int. J. Environ. Res. Public Health 2020, 17(12), 4571; https://doi.org/10.3390/ijerph17124571 - 25 Jun 2020

Cited by 15 | Viewed by 6548

Abstract

The evidence of the economic burden of road traffic injuries (RTIs) in Nepal is limited. The most recent study, conducted in 2008, is now considered outdated because there has been a rapid increase in vehicle numbers and extensive road building over the last decade. This study estimated the current economic costs of RTIs in Nepal, including the direct costs, productivity costs, and valuation of pain, grief, and suffering. An incidence-based cost-of-illness analysis was conducted from a societal perspective, employing a bottom-up approach using secondary data. All costs incurred by the patients, their family members, and costs to society were estimated, with sensitivity analyses to consider uncertainty around the data estimates available. Productivity loss was valued using the human capital approach. The total costs of RTIs in 2017 were estimated at USD 122.88 million. Of these, the costs of productivity loss were USD 91.57 million (74.52%) and the pain, grief, and suffering costs were USD 18.31 million (14.90%). The direct non-medical costs were USD 11.50 million (9.36%) whereas the direct medical costs were USD 1.50 million (1.22%). The economic costs of RTIs increased by threefold since 2007 and are equivalent to 1.52% of the gross national product, indicating the growing national financial burden associated with preventable RTIs. Full article

(This article belongs to the Special Issue Health-Related Quality of Life, Patient Relevant Outcomes and Economic Impact of Injuries)

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