Medical Cost of Burn Patient in National Trauma and Orthopedic Research Center, Mongolia

Abstract

Abstract Background: The accidents and injuries are the major causes of the morbidity and mortality as the 90% of them occurring in the low- and middle-income countries. And the burn injuries are becoming more public health issues throughout the world. The cost of caring for a burns patient is known to be higher than for non-burns patients. However, there is little written on the cost of burns care. Studies of burn injuries are commonly related to hospital utilizations and its costs but there are needs to define how much money spent from the patient for the burn care. Methods: Totally 116 burn patients who hospitalized at National Traumatology and Orthopedic Reseach Center (NTORC) participated in the study between the August 1st, 2016 and August 31st, 2016. We analyzed demographics and medical costs of adult (age>20) and child (age<11) patients. In this study, we created multiple linear regression model and logistic regression model to predict the medical cost of the burn patient. Results: The mean of total out-of-pocket costs of burn injuries in NTORC were 536902.65 MNT (241.89 USD) per inpatient. As a result of multiple regression model among adult patients, that inpatient who lives in the rural area spend 461327 MNT more than inpatient who lives in the urban area. Besides, insured patients spend 261973 MNT more than the uninsured patient. The employed patient pays 433732 MNT more than the unemployed patient. The total cost of burn inpatient treatment for the adult patient will increase 16284 MNT if the percent of total body surface area (%TBSA) increase by 1 percent. And multiple regression model among child patients, inpatient who live in the urban area spent 127801 MNT more than inpatients who live in rural area. Also, insured patients spend 65951 MNT more than the uninsured patient. The only %TBSA was a significant predictor of the total cost of burn inpatient treatment. The total cost of burn inpatient treatment for child patient will increase 10955 MNT if %TBSA increase by 1 percent. We did not find many statistically significant variables from logistic regression models of both adult and child patients. However, middle education levels for both models of adult and child patients were statistically significant. Exp (B) value indicates that when middle education is raised by one unit the odd ratio is 33 times as large and therefore children are 33 more times likely to show high-cost and it was almost two times higher than adult patients in our study. Discussion: Our study objective was to determine the medical cost of burn patients in burn inpatients. The mean total medical cost per burn patient was 536902.65 MNT (241.89 USD) per patient within one-month treatment in NTORC. Our result of mean total medical cost per burn patient can not represent the true cost of the burn patient. Because we only studied one-month costs which paid by burn patient. Sanchez et al., (2007)’s study mentioned medical costs represent only 10% of total costs. In other words, other 90% of costs include costs of productivity losses and informal care (Sánchez et al., 2007). Mashreky et al., (2008) assessed the burden of burn injury costs and burn admission was significantly (p=0.000) high in a younger age group in their study results (Mashreky et al., 2008). But in our case, mean total cost of burn patient among adult patients (667677 MNT) was higher than child patients (443776 MNT). Similarly, Hop et al., (2016)’s study results show that adult patients were significantly costly than children. Klein et al., (2008)’s study conducted to evaluate the potential impact of the urban and rural area on hospital costs of the burn patient. The most rural areas tended to have higher costs in this study (Klein et al., 2008). It is similar to our result of location. According to our results, the size of burn surface area, location, employment status, insurance are the most influential indicators. More statistically significant variables found in multi...