Risk of Catastrophic Health Expenditure in Rwandan Surgical Patients with Peritonitis.

Area of Science:

• Global Surgery
• Health Economics
• Public Health

Background:

• Surgical procedures are cost-effective interventions.
• Peritonitis often necessitates surgery, but its economic impact, especially in low- and middle-income countries, is understudied.
• Understanding peritonitis treatment costs is crucial for financial risk assessment.

Purpose of the Study:

• To determine in-hospital charges for peritonitis patients in Rwanda.
• To assess the risk of catastrophic health expenditure among these patients.

Main Methods:

• Prospective enrollment of patients undergoing surgery for peritonitis.
• Analysis of in-hospital charges and patient out-of-pocket expenses.
• Logistic regression to identify factors associated with catastrophic health expenditure.

Main Results:

• Over a 6-month period, 280 patients underwent surgery for peritonitis.
• Median total hospital charges were $308.1 USD, with patients paying a median of $26.9 USD.
• 14% of patients faced catastrophic expenditure based on direct medical costs, rising to 28% when including non-medical expenses.

Conclusions:

• Despite health insurance, a substantial proportion of peritonitis patients are at risk of catastrophic health expenditure.
• Unplanned reoperations significantly increase this financial risk.
• Community-based health insurance was associated with a reduced risk of catastrophic health expenditure.