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  • Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka

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    Wickramasinghe222092-Published.pdf (421.5Kb)
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    Author(s)
    Wickramasinghe, Kanchana
    Steele, Paul
    Dawson, Andrew
    Dharmaratne, Dinusha
    Gunawardena, Asha
    Senarathna, Lalith
    de Siva, Dhammika
    Wijayaweera, Kusal
    Eddleston, Michael
    Konradsen, Flemming
    Griffith University Author(s)
    Wickramasinghe, Kanchana
    Year published
    2009
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    Abstract
    Objective To estimate the direct financial costs to the Sri Lanka Ministry of Health of treating patients after self-poisoning, particularly from pesticides, in a single district. Methods Data on staff, drug, laboratory and other inputs for each patient admitted for self-poisoning were prospectively collected over a one-month period from one general hospital (2005) and five peripheral hospitals (2006) in the Anuradhapura district. Data on transfers to secondary- and tertiary-level facilities were obtained for a 6-month period from 30 peripheral hospitals. The cost of the inputs in United States dollars (US$), using 2005 ...
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    Objective To estimate the direct financial costs to the Sri Lanka Ministry of Health of treating patients after self-poisoning, particularly from pesticides, in a single district. Methods Data on staff, drug, laboratory and other inputs for each patient admitted for self-poisoning were prospectively collected over a one-month period from one general hospital (2005) and five peripheral hospitals (2006) in the Anuradhapura district. Data on transfers to secondary- and tertiary-level facilities were obtained for a 6-month period from 30 peripheral hospitals. The cost of the inputs in United States dollars (US$), using 2005 figures, was derived from hospital accounts. Findings The average total cost of treating a self-poisoned patient at the general hospital was US$ 31.83, with ward staff input and drugs being the highest expenditure category and only US$ 0.19 of this sum related to capital and maintenance costs. The average total cost of treatment was highest for self-poisoning with pesticides (US$ 49.12). The patients placed in the intensive care unit, who comprised 5% of the total, took up 75% of the overall treatment cost for all self-poisoned patients at the general hospital. The average total cost of treating self-poisoned patients at peripheral hospitals was US$ 3.33. The average patient cost per transfer was US$ 14.03. In 2006, the total cost of treating self-poisoned patients in the Anuradhapura district amounted to US$ 76 599, of which US$ 53 834 were comprised of pesticide self-poisonings. Based on the total treatment cost per self-poisoned patient estimated in this study, the cost of treating self-poisoned patients in all of Sri Lanka in 2004 was estimated at US$ 866 304. Conclusion The cost of treating pesticide self-poisonings may be reduced by promoting the use of less toxic pesticides and possibly by improving case management in primary care hospitals. Additional research is needed to assess if increasing infrastructure and staff at peripheral hospitals could reduce the overall cost to the government, optimize case management and reduce pressure on secondary services,.
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    Journal Title
    Bulletin of the World Health Organization
    Volume
    87
    Issue
    3
    DOI
    https://doi.org/10.2471/BLT.08.051920
    Copyright Statement
    © 2009 World Health Organization. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
    Subject
    Biomedical and clinical sciences
    Science & Technology
    Life Sciences & Biomedicine
    Public, Environmental & Occupational Health
    PESTICIDE
    Publication URI
    http://hdl.handle.net/10072/400551
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    • Journal articles

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