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Implications of patient-borne costs associated with pediatric neurosurgical care in eastern Africa
Jonathan Awori1,2, Jennifer Strahle1, Humphrey Okechi3
1Department of Neurosurgery and.
Insights
Pediatric neurosurgery is cost-effective but inaccessible in developing nations. Patient families bear significant costs, often exceeding their annual income, hindering access to essential neurosurgical care.
Area of Science:
- Global Health
- Pediatric Neurosurgery
- Health Economics
Background:
- Pediatric neurosurgery offers significant cost-effectiveness in developing countries.
- Service delivery is constrained by limited healthcare infrastructure and patient resources.
- Limited research exists on patient-borne costs in pediatric neurosurgery in low-resource settings.
Purpose of the Study:
- To evaluate the direct and indirect costs incurred by families of pediatric neurosurgery patients in a developing country.
- To assess the implications of these patient-borne costs on accessing neurosurgical care.
Main Methods:
- A survey was conducted with families of 40 pediatric neurosurgery patients at AIC Kijabe Hospital, Kenya.
- Costs associated with inpatient neurosurgical care were assessed in February 2015.
Main Results:
- Families incurred average neurosurgical service costs of US $539.44, equivalent to 132% of their annual income.
- Indirect expenses (transport, food, lodging, lost wages) averaged US $79.37, representing 14.7% of total costs and 19.5% of annual income.
Conclusions:
- Expanding pediatric neurosurgical services globally requires addressing patient- and family-borne expenses.
- Even with "free" institutional care, extreme poverty can prevent some patients from accessing necessary neurosurgical treatment without additional financial support.
Abstract:
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.
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