• Hailu Tamiru Dhufera, Abdulrahman Jbaily, Stéphane Verguet, Mieraf Taddesse Tolla, Kjell Arne Johansson, and Solomon Tessema Memirie.
• Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: hdhufera@hsph.harvard.edu.
• Injury. 2022 Jan 1; 53 (1): 232923-29.

BackgroundRoad traffic injuries are among the most important causes of morbidity and mortality and cause substantial economic loss to households in Ethiopia. This study estimates the financial risks of seeking trauma care due to road traffic injuries in Addis Ababa, Ethiopia.MethodsThis is a cross-sectional survey on out-of-pocket (OOP) expenditures related to trauma care in three public and one private hospital in Addis Ababa from December 2018 to February 2019. Direct medical and non-medical costs (2018 USD) were collected from 452 trauma cases. Catastrophic health expenditures were defined as OOP health expenditures of 10% or more of total household expenditures. Additionally, we investigated the impoverishment effect of OOP expenditures using the international poverty line of $1.90 per day per person (adjusted for purchasing power parity).ResultsTrauma care seeking after road traffic injuries generate catastrophic health expenditures for 67% of households and push 24% of households below the international poverty line. On average, the medical OOP expenditures per patient seeking care were $256 for outpatient visits and $690 for inpatient visits per road traffic injury. Patients paid more for trauma care in private hospitals, and OOP expenditures were six times higher in private than in public hospitals. Transport to facilities and caregiver costs were the two major cost drivers, amounting to $96 and $68 per patient, respectively.ConclusionSeeking trauma care after a road traffic injury poses a substantial financial threat to Ethiopian households due to lack of strong financial risk protection mechanisms. Ethiopia's government should enact multisectoral interventions for increasing the prevention of road traffic injuries and implement universal public finance of trauma care.Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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