Evidence map›Paper›PMID 32524159›Full record

ArticleWorld journal of surgery2020

Financial Risk Protection and Hospital Admission for Trauma in Cameroon: An Analysis of the Cameroon National Trauma Registry.

Pooja A Shah, S Ariane Christie, Girish Motwani, Fanny Nadia Dissak-Delon, Alain Chichom Mefire, David Mekolo, Gertrude Mete Ngono, Rochelle Dicker, Georges Alain-Mballa Etoundi, Catherine Juillard

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Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Pooja A ShahCenter for Global Surgical Studies, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
S Ariane ChristieCenter for Global Surgical Studies, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
Girish MotwaniCenter for Global Surgical Studies, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
Fanny Nadia Dissak-DelonLittoral Regional Delegation, Ministry of Public Health, Douala, Cameroon.
Alain Chichom MefireDepartment of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
David MekoloEmergency Unit, Laquintinie Hospital of Douala, Douala, Cameroon.
Gertrude Mete NgonoCatholic Hospital of Pouma, Pouma, Cameroon.
Rochelle DickerDepartment of Surgery, University of California, 10833 Le Conte Avenue, 72215 CHS, Los Angeles, CA, 90095, USA.
Georges Alain-Mballa EtoundiCameroon Department of Disease Control, Ministry of Public Health, Yaoundé, Cameroon.
Catherine JuillardDepartment of Surgery, University of California, 10833 Le Conte Avenue, 72215 CHS, Los Angeles, CA, 90095, USA. CJuillard@mednet.ucla.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHalf of the global population is at risk for catastrophic health expenditure (CHE) in the event that they require surgery. Universal health coverage fundamentally requires protection from CHE, particularly in low- and middle-income countries (LMICs). Financial risk protection reports in LMICs covering surgical care are limited. We explored the relationship between financial risk protection and hospital admission among injured patients in Cameroon to understand the role of health insurance in addressing unmet need for surgery in LMICs.

methodsThe Cameroon National Trauma Registry, a database of all injured patients presenting to the emergency departments (ED) of three Cameroonian hospitals, was retrospectively reviewed between 2015 and 2017. Multivariate regression analysis identified predictors of hospital admission after injury and of patient report of cost inhibiting their care.

resultsOf the 7603 injured patients, 95.7% paid out-of-pocket to finance ED care. Less than two percent (1.42%) utilized private insurance, and more than half (54.7%) reported that cost inhibited their care. In multivariate analysis, private insurance coverage was a predictor of hospital admission (OR 2.17, 95% CI: 1.26, 3.74) and decreased likelihood of cost inhibiting care (OR 0.34, 95% CI: 0.20, 0.60) when compared to individuals paying out-of-pocket.

conclusionThe prevalence of out-of-pocket spending among injured patients in Cameroon highlights the need for financial risk protection that encompasses surgical care. Patients with private insurance were more likely to be admitted to the hospital, and less likely to report that cost inhibited care, supporting private health insurance as a potential financing strategy.

Indexed as

Health ExpendituresRegistriesAdolescentAdultAgedAged, 80 and overCameroonChildEmergency Service, HospitalFemaleHospitalizationHumansInsurance CoverageMaleMiddle AgedPatient Admission

Identifiers

PMID32524159

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.