Risk factor profile and the cost of traffic injury in a tertiary hospital in Kenya.

The objective is to evaluate the risk factors and in-patient cost of traffic injury. This prospective consecutive case study was performed at the Kenyatta National Hospital (KNH). A total of 233 crash victims, 134 non-traffic trauma patients and 87 non-trauma patients admitted to the surgical units between February, 1st 1999 and April, 30th, 1999 were enrolled. Information on age, gender and occupation of the patients, payer category, alcohol use, length of hospital stay, hospital cost and principal region of injury were gathered through patient interviews and review of case notes, operation notes, treatment records and discharge summaries. Data analysis was performed using SPSS-version 9.0 statistical software. Road trauma admissions comprised about 31 per cent of all admissions due to injury, 15.1 per cent of surgical admissions and 4.5 per cent of emergency hospital admissions. The male sex occupation status and regular use of alcohol appeared to be significant risk factors for injury occurrence. Injury occurrence showed no correlation with age and marital status. The respective hospital costs for non-RTA trauma and non-trauma patients were 2.2 and 1.9 times higher as compared to RTA trauma patients. The capacity of the injured to compensate for the care given was minimal. In only 6 per cent of the RTA patients was the hospital bill cleared through a health insurance agency or medical scheme. Road traffic injury is common, costly, places considerable workload to the hospital and preferentially occurs in productive males. It is suggested that the current orientation of trauma care delivery cannot be sustained. Cost containment strategies including the re-examination of the national health insurance scheme may be the way forward to reduce the cost of injury. (A) For the covering abstract of the conference see ITRD no 207828. The reprints are also available at the web - http://www.vti.se/pdf/reports/K18APart1.pdf; http://www.vti.se/pdf/reports/K18APart2.pdf and http://www.vti.se/pdf/reports/K18APart3.pdf.