|Year : 2012 | Volume
| Issue : 1 | Page : 53-54
Analyzing the socio-economic cost of burn care
Divya Narain Upadhyaya, Vaibhav Khanna
Department of Plastic Surgery, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
|Date of Web Publication||13-May-2013|
Divya Narain Upadhyaya
B-2/128, Sector - F, Janakipuram, Lucknow – 226 021
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Upadhyaya DN, Khanna V. Analyzing the socio-economic cost of burn care. Indian J Burns 2012;20:53-4
Burns cause morbidities which not only are limited merely to the physical health of the patient but also have social, economic, and psychological ramifications. Treatment of burns is prolonged, often requiring staged surgeries, intensive nursing care, and prolonged rehabilitative support. Understandably, burn care is known to be among the most costly areas of healthcare.  However, few authors all over the world have invested time in elucidating the socio-economic burden of burn care. , The largest such study has been done by Sanchez and others where the authors have analyzed the data of 898 patients in 2003 collected through hospital records as well as by patient questionnaires. The study brought up some amazing results; the mean annual cost per burn patient according to this study was USD 99,773 of which direct healthcare costs comprised only 19.6%.  The total annual cost for burn care in Spain as reported by these investigators was a staggering USD 313 million.
Socio-economic cost calculation consists of social and economic components. The social cost can be calculated by using an appropriately designed Health Related Quality of Life Score (HRQOL) which should include the patient's perception of his/her disability and the physical and psychological impediment caused due to the burn. Economic burden can be divided into direct and indirect costs. Indirect costs consist of calculation of monetary loss due to work loss, temporary, and permanent disability and/or death. Direct costs can again be health-related or nonhealthcare costs. Direct healthcare costs include cost of hospitalization, surgeries, intensive care, nursing, and drug/disposable costs. Direct nonhealthcare costs cover the economic burden of maintaining/rehabilitating the burn patient into his or her daily life and include performance of professional tasks (for example by a physiotherapist) as well as those performed by lay persons/family members.  Most of the developed countries have healthcare systems where the costs are borne either by the government or health insurance providers. This makes burn care feasible for the patient which otherwise would be unbearable for the individual, as is the case in India.
In the present study the economic burden of burn care per patient (in a municipal hospital with subsidized fares) has been found by the investigators to be in the range of USD 690-1153. This study examines a very important aspect of burn care which has hitherto been largely untouched. It is, however, severely limited in the areas of sample size and study design. If any logical and reliable conclusions have to be drawn from such an exercise, the scope of the investigation has to be expanded and the sample size increased several fold.
Another study worth mentioning is by S. R. Mashreky and others  where the authors have examined the records of 791 burn patients admitted to 16 district hospitals and 45 upazila health centers (district subunits) in Bangladesh. The authors found burn injuries to constitute 2% of all injury admissions over a period of 1 year. These patients had the longest hospital stay and the highest management costs of all the admissions during that period. Such prohibitive costs preclude effective and efficient management of burn injuries especially in developing or underdeveloped nations where health care cost is not borne by either the state or health insurance providers. An effective burn prevention program is thus the best option for circumventing the enormous socio-economic impact of burn injuries in these countries. These costs, which are almost always borne by the patients and their family, cause a heavy damage to the fragile socio-economic balance of these families, the impact of which is at least difficult, if not impossible, to measure at the moment. Large burn centers admitting and managing burn patients have to take the initiative in assessing the cost of burn care in India along with suitable help from the state machinery/nongovernmental organizations. Compulsory reporting of burn injuries and establishment of a central burn registry shall go a long way in assessment of the status of burn care in India and in formulating effective policies for its prevention.
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