Multiple Burden of Road Traffic Crashes among Risk Groups: A Patient Perspective Approach in Mid-hilly District of Nepal

BackgroundThe economic burden and cost-related evidence from primary data of road traffic crashes (RTCs) in Nepal are limited. AimThis study assessed the disability-adjusted life years (DALYs), the cost associated with RTCs, and socio-demographic and injury related factors. MethodsWe carried out a retrospective cross-sectional, institution-based survey of the RTC victims in the last one year to 45 days prior to the survey, in Pokhara and the surroundings in Kaski district, a mid-hilly district and the headquarter of Gandaki province of Nepal. A sample of 107 RTC victims, registered in different hospitals, police offices and health insurance offices, were retrospectively approached. A semi-structured interview schedule was used to collect data. Data were entered into EpiData before being imported, and analysed in the Statistical Package for Social Sciences (SPSS) and MS-Excel. Descriptive statistics were generated by calculating costs and DALYs, and inferential analysis was used to investigate the relationship between DALYs and independent variables. ResultsMore than one-third (37.4%) of the 107 victims were between the ages of 25 and 44, and more than half (60.7%) were men. The cost per million person-years of RTC was around US $ 82,800. Similarly, around 1021 DALYs per million person-years are attributed to RTC, and more than 99% of them are shared by YLL. We observed the highest number of frequencies of young (p<.01), having university degree (p<.01), unemployed (p<.05), motorcyclists (p<.01), highest economic quintile (p<.01), and seriously injured (p<.01). In addition, we also observed a low positive correlation (r=0.33, p<.01) between DALYs and the victims indirect cost. ConclusionThe cost and DALYs associated by RTC of Kaski district were around US $ 82,800 and 1021 per million person-years in 2017, respectively. Young unemployed motorcyclists were the most frequent victims. Victims indirect cost is increased with DALYs, suggesting a policy implication.