The Economic Burden of Road Traffic Injuries on Households in South Asia

PLoS One

Ajay Mahal¹  Khurshid Alam² 

[1] Department of Pediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052, Australia;Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia

关键词: Health economics;    Asia;    Socioeconomic aspects of health;    Global health;    Economics;    Roads;    Finance;    Bangladesh;   

DOI  :  10.1371/journal.pone.0164362

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Globally, road traffic injuries accounted for about 1.36 million deaths in 2015 and are projected to become the fourth leading cause of disability-adjusted life years (DALYs) lost by 2030. One-fifth of these deaths occurred in South Asia where road traffic injuries are projected to increase by 144% by 2020. Despite this rapidly increasing disease burden there is limited evidence on the economic burden of road traffic injuries on households in South Asia. We applied a novel coarsened exact matching method to assess the household economic burden of road traffic injuries using nationally representative World Health Survey data from five South Asian countries- Bangladesh, India, Nepal, Pakistan and Sri Lanka collected during 2002–2003. We examined the impact of road traffic injuries on household out-of-pocket (OOP) health spending, household non-medical consumption expenditure and the employment status of the traffic injury-affected respondent. We exactly matched a household (after ‘coarsening’) where a respondent reported being involved in a road traffic injury to households where the respondent did not report a road traffic injury on each of multiple observed household characteristics. Our analysis found that road traffic injury-affected households had significantly higher levels of OOP health spending per member (I$0.75, p<0.01), higher OOP spending on drugs per member (I$0.30, p = 0.03), and higher OOP hospital spending per member (I$0.29, p<0.01) in the four weeks preceding the survey. Indicators of “catastrophic spending” were also significantly higher in road traffic injury-affected households: 6.45% (p<0.01) for a threshold of OOP health spending to total household spending ratio of 20%, and 7.40% (p<0.01) for a threshold of OOP health spending to household ‘capacity to pay’ ratio of 40%. However, no statistically significant effects were observed for household non-medical consumption expenditure, and employment status of the road traffic injury-affected individual. Our analysis points to the need for financial risk protection against the road traffic injury-related OOP health expenditure and a focus on prevention.

【 授权许可】

CC BY