Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model.
<h4>Background</h4>Trauma and injury present a significant global burden-one that is exacerbated in low- and middle-income settings like Tanzania. Our study aimed to describe the landscape of acute injury care and financial toxicity in the Kilimanjaro region by leveraging the Three Delay...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2024-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0308539 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849228170345054208 |
|---|---|
| author | Parker Frankiewicz Yvonne Sawe Francis Sakita Blandina T Mmbaga Catherine Staton Anjni P Joiner Emily R Smith |
| author_facet | Parker Frankiewicz Yvonne Sawe Francis Sakita Blandina T Mmbaga Catherine Staton Anjni P Joiner Emily R Smith |
| author_sort | Parker Frankiewicz |
| collection | DOAJ |
| description | <h4>Background</h4>Trauma and injury present a significant global burden-one that is exacerbated in low- and middle-income settings like Tanzania. Our study aimed to describe the landscape of acute injury care and financial toxicity in the Kilimanjaro region by leveraging the Three Delays Model.<h4>Methods</h4>This cross-sectional study used an ongoing injury registry and financial questionnaires collected at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania from December 2022 until March 2023. Financial toxicity measures included catastrophic expenditure and impoverishment, in accordance with World Health Organization standards. Descriptive analysis was also performed.<h4>Findings</h4>Most acute injury patients that presented to the KCMC Emergency Department experienced financial toxicity due to their out-of-pocket (OOP) hospital expenses (catastrophic health expenditure, CHE: 62.8%; impoverishment, IMP: 85.9%). Households within our same which experienced financial toxicity had more dependents (CHE: 18.4%; IMP: 17.9% with ≥6 dependents) and lower median monthly adult-equivalent incomes (CHE: 2.53 times smaller than non-CHE; IMP: 4.27 times smaller than non-IMP). Individuals experiencing financial toxicity also underwent more facility transfers with a higher surgical burden.<h4>Interpretation</h4>Delay 1 (decision to seek care) and Delay 2 (reaching appropriate care facility) could be significant factors for those who will experience financial toxicity. In the Tanzanian healthcare system where national health insurance is present, systematic expansions are indicated to target those who are at higher risk for financial toxicity including those who live in rural areas, experience unemployment, and have many dependents. |
| format | Article |
| id | doaj-art-9fd5da91cd824a72acb04c59146f435c |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-9fd5da91cd824a72acb04c59146f435c2025-08-23T05:32:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01198e030853910.1371/journal.pone.0308539Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model.Parker FrankiewiczYvonne SaweFrancis SakitaBlandina T MmbagaCatherine StatonAnjni P JoinerEmily R Smith<h4>Background</h4>Trauma and injury present a significant global burden-one that is exacerbated in low- and middle-income settings like Tanzania. Our study aimed to describe the landscape of acute injury care and financial toxicity in the Kilimanjaro region by leveraging the Three Delays Model.<h4>Methods</h4>This cross-sectional study used an ongoing injury registry and financial questionnaires collected at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania from December 2022 until March 2023. Financial toxicity measures included catastrophic expenditure and impoverishment, in accordance with World Health Organization standards. Descriptive analysis was also performed.<h4>Findings</h4>Most acute injury patients that presented to the KCMC Emergency Department experienced financial toxicity due to their out-of-pocket (OOP) hospital expenses (catastrophic health expenditure, CHE: 62.8%; impoverishment, IMP: 85.9%). Households within our same which experienced financial toxicity had more dependents (CHE: 18.4%; IMP: 17.9% with ≥6 dependents) and lower median monthly adult-equivalent incomes (CHE: 2.53 times smaller than non-CHE; IMP: 4.27 times smaller than non-IMP). Individuals experiencing financial toxicity also underwent more facility transfers with a higher surgical burden.<h4>Interpretation</h4>Delay 1 (decision to seek care) and Delay 2 (reaching appropriate care facility) could be significant factors for those who will experience financial toxicity. In the Tanzanian healthcare system where national health insurance is present, systematic expansions are indicated to target those who are at higher risk for financial toxicity including those who live in rural areas, experience unemployment, and have many dependents.https://doi.org/10.1371/journal.pone.0308539 |
| spellingShingle | Parker Frankiewicz Yvonne Sawe Francis Sakita Blandina T Mmbaga Catherine Staton Anjni P Joiner Emily R Smith Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model. PLoS ONE |
| title | Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model. |
| title_full | Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model. |
| title_fullStr | Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model. |
| title_full_unstemmed | Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model. |
| title_short | Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model. |
| title_sort | financial toxicity and acute injury in the kilimanjaro region an application of the three delays model |
| url | https://doi.org/10.1371/journal.pone.0308539 |
| work_keys_str_mv | AT parkerfrankiewicz financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel AT yvonnesawe financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel AT francissakita financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel AT blandinatmmbaga financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel AT catherinestaton financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel AT anjnipjoiner financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel AT emilyrsmith financialtoxicityandacuteinjuryinthekilimanjaroregionanapplicationofthethreedelaysmodel |