The Socio-Economic Burden of Paediatric Long Bone Fractures in A Low Resource Setting

Abstract

Objective: Paediatric long bone fractures are prevalent and a significant source of direct medical costs and indirect costs resulting from economic production losses within affected families. Our study aimed to describe the occurrence of paediatric long bone fractures and its direct and indirect costs to the affected families.
Methods: A prospective review and follow-up of all paediatric long bone fracture admissions at KATH A&E was conducted from March to June 2018. The study assessed the socio-economic burden of paediatric long bone fractures on the patients and caregivers.
Results: In the period, 97 children presented with mean age of 6.7years (SD=3.9 years) and 63.9% being male. Mechanism of injury was mostly falling during walking or running (39.1%) and 19.6% were pedestrian knockdowns. Most injuries occurred at home (41.2%)
and school (30.9%) and 13.4% reported to the hospital in an ambulance. The most common fracture was both radius and ulna (26.8%) and closed fractures (83.5%) with 10.5% undergoing operative management. Caregivers were mostly females (67.0%) and the mean
age was 39.3 years (SD=11.8years). The mean direct cost of treatment was GHS 928.91 (SD=GHS 1683.97) for all patients and GHS 3,587.50 (SD=GHS 3401.87) for surgically managed patients. The mean cost of treatment covered by health insurance was GHS 348.83
(SD=GHS 738.64). Mean missed workdays for caregivers was 24.5days (SD=31.1days)
Conclusion: Fractures of both radius and ulna were common in our paediatric population and occurred mostly at home. Paediatric fractures have a significant socioeconomic burden on the caregivers. There is the need to advocate for injury prevention strategies that
target safety at home and in school.