ABSTRACT
Background:Traumatic Spinal Cord Injury (TSCI) is a costly condition in human and economic terms. Yet, studies on direct cost of treatment for TSCI in resource-constraint countries are sparse.Objective:To estimate the direct cost of treatment for patients with TSCI at the University College Hospital (UCH), Ibadan, Nigeria using an incidence-based costing approache Methods:All new cases of TSCI admitted in the hospital from January, 2009 to December, 2013 were identified and reviewed. Direct costs of in-patient and out-patient treatments over the first year of injury were estimated.Results:114 individuals with TSCI (73 males; 41 females) were admitted and discharged home alive from the hospital. The largest cost driver to the patients and the National Health Insurance Scheme was cost of consultations by neurosurgeons which constituted about a third (34.4%) of the total costs of treatment. Less than a fourth (24.2%) of the total cost of in-patient treatment was spent on therapeutic interventions (surgery, drugs and physiotherapy). There was a significant relationship between the direct cost of treatment and each of the severity of traumatic spinal cord injury and length of hospital stay (p = 0.01). Level of injury was not significantly associated with direct cost of treatment (p=0.89).Conclusion:Direct cost of treatment for individuals with TSCI in Ibadan, Nigeria is substantial. This high cost underscores the need for novel service models with potential for minimizing cost for patients with TSCI in Nigeria
Subject(s)
Cost of Illness , Health Care Costs , Nigeria , Spinal Cord InjuriesABSTRACT
Background:Stroke is a leading cause of death both globally, and in Africa. The attendant effect of the stroke is disability, loss of function and psychosocial issues. Studies have been carried out on different rehabilitation outcomes such as participation, self-motivation and functional ability related to stroke survivors. There is however a dearth of studies exploring the relationships among self-motivation, functional ability and participation of stroke survivors, particularly in our African community.Objectives:Relationship among participation, self-motivation and functional ability of stroke survivors residing in Ibadan was investigated.Methods:This was a cross-sectional survey which involved 44 consenting stroke survivors. Clinical and demographic information were documented. Self-motivation, functional ability and participation of the stroke survivors were assessed with the Self-Motivation Inventory, Fugl-Meyer Assessment of Motor Recovery after Stroke; and London Handicap Scale respectively. Data was analysed with descriptive statistics and inferential statistics of Spearman Rank Correlation at p= 0.05.Results:There was a statistically significant positive correlation between the time since onset of stroke scores and participation (p= 0.02) and between the stroke survivors' functional ability and participation scores (p=0.001). Conversely there was no significant relationship between the participants' functional ability and time since onset of stroke scores (p= 0.62), between stroke survivors' self-motivation and time since onset of stroke scores (p= 0.41), between self-motivation and participation (p=0.80) and between self-motivation and functional ability scores (p= 0.80)Conclusions:Whereas self-motivation appeared non-related to functional ability and participation, a more exploration of the subject matter is still necessary for a conclusive inference to be drawn, especially in view of the sample size involved in this present study