Browsing by Author "Karanja, Lorna Wangari"

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    An Analysis of Patients’ Spinal Injury Costs at the National Spinal Injury Hospital in Nairobi County, Kenya
    (Global scientific journal, 2024) Korir, julius k.; Karanja, Lorna Wangari; Yitambe, Andre
    Global statistics indicate that based on the extent of spinal cord injury, the first-year cost ranges between $300,000 and $1,000,000. [1]. A review of 68 studies [2], indicated the cost of injury varied widely with mean costs ranging from $14 to $17, 400 and the cost per disability-adjusted life year averted for injury-prevention interventions ranged from $10.90 for speed bump installation to $17,000 for drunk driving and breath testing campaigns in Africa. Health economists are interested in evaluating spinal cord treatment interventions as economic investments. For these stakeholders, a key question is the relationship between the reduction of spinal cord injuries and national income growth as measured by GDP metrics. Public health officials are more focused on promoting health, preventing spinal injuries and related mortalities as well as reducing their health and social burden. The general objective of this study was to analyze the patient costs of spinal cord injury at the National Spinal Injury Hospital, Nairobi County, Kenya. The four specific objectives of the study were to determine the total costs of spinal cord injury in the first year of diagnosis and treatment at the National Spinal Injury Hospital, to determine the variations in total costs of spinal cord injury due to ownership of health insurance, to establish the variations in total costs of spinal cord injury based on extent of the injury and to establish the variations in total costs of spinal cord injury based on the employment status of the patients at National Spinal Injury Hospital.This was an analytical cross-sectional study utilizing quantitative methods on a sample of n=169. Purposive sampling was also employed to recruit participants comprising spinal injury patients in the first year of diagnosis and data were collected using structured questionnaires and secondary data review. Data was analyzed using SPSS version 25 where descriptive statistics were used to show frequencies and percentages for variables. ANOVA test was used to test the statistical mean differences in the total SCI costs among the SCI patients at NSIH based on their employment status and extent of the spinal injury while paired t-test was used for health insurance status. Findings indicate that it average costs the spinal cord injury patient KSh. 928,326.73 in treatment costs in the first year of diagnosis. The average of sum of the annual direct medical costs, direct non-medical costs and indirect costs of productivity losses for the 169 patients was KSh 187,048, KSh 173,541 and KSh 567,738 per patient respectively. Further, it shows that the employment status of the patients do result in significant differences in the total SCI costs among the different groups ( P=0.000) while the extent of injury and health insurance status does not result in significant differences in the total SCI costs( P=0.6617 and t=-0.6129 respectively). This study will inform the National Spinal Injury Hospital on the importance of health economic studies in the management of SCI patients.
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    Analysis of Patients’ Direct and Indirect Costs at the National Spinal Injury Hospital in Nairobi City County, Kenya
    (Kenyatta University, 2025-04) Karanja, Lorna Wangari
    Global statistics indicate that based on the extent of spinal cord injury, the first-year cost ranges between $300,000 and $1,000,000. A review of 68 studies by Hadley et.al 2013, revealed that the average cost of an accident varied greatly, from $14 to $17,400. The cost per disability-adjusted life year saved by injury-prevention measures ranged from $10.90 for the installation of speed bumps to $17,000 for campaigns against drunk driving and breathalyser testing in Africa. This study aimed to determine the economic burden of spinal cord injury (SCI) by analyzing patients’ spinal injury costs at the National Spinal Injury Hospital (NSIH) in Nairobi, Kenya. The specific objectives were to: (i) determine the total costs of SCI in the first year of diagnosis and treatment; (ii) analyze variations in costs due to health insurance ownership; (iii) assess cost variations based on the extent of injury; and (iv) examine cost variations based on the employment status of patients. A cross-sectional analytical study was conducted using purposive sampling to select the hospital, the only referral facility for SCI in East Africa. SCI inpatients and outpatients meeting the inclusion criteria were recruited using consecutive sampling until the sample size of 169 was reached. Data were collected through structured questionnaires and secondary data review and analyzed using SPSS version 25. Findings revealed that the average first-year cost of SCI per patient was KSh. 928,326.73, comprising KSh. 187,048 in direct medical costs, KSh. 173,541 in direct non-medical costs, and KSh. 567,738 in indirect productivity losses. Statistical analysis showed no significant difference in total spinal cord injury costs between patients with medical cover and those without medical cover (df=2t=0.6129) or patients with different extents of injury (df=3; P=0.6617), but patients’ employment statuses significantly influenced the total spinal cord injury costs (df=4; P=0.0000). The conclusions were (i) There is no significant difference in the total SCI costs between the SCI patients with medical cover and those without medical cover (ii) There is a significant difference in the total SCI costs amongst SCI patients of different employment statuses (iii) There is no significant difference in the total SCI costs among the SCI patients with different extents of the injury. Recommendations include reducing indirect costs through modern treatment technologies and affirmative actions, promoting the full implementation of the Social Health Insurance Act, providing direct cash transfers to SCI patients, and encouraging employers to support SCI patients with flexible work arrangements and workplace modifications. These findings emphasise the need for targeted interventions to alleviate the economic burden of SCI and enhance patient care at NSIH.