Assessing the Cost Burden of Pediatric Neurosurgery in Kaduna, Nigeria

World Neurosurg. 2021 Aug:152:e708-e712. doi: 10.1016/j.wneu.2021.06.014. Epub 2021 Jun 12.

Abstract

Background: Few studies have evaluated the cost burden borne by neurosurgical patients in the developing world and their potential implications for efficient and effective delivery of care. This study aims to assess the cost associated with obtaining pediatric neurosurgical care in a hospital in Kaduna.

Methods: All patients younger than 15 years who had a neurosurgical operation from July to December 2019 were included in the study. The characteristics of the patients were obtained using a proforma while the cost data were retrieved from the accounts unit of the hospital. The direct cost was obtained from the billing records of the hospital. Indirect cost was obtained using a questionnaire. The data obtained were analyzed using SPSS version 25 for Windows.

Results: A total of 27 patients were included in the study with a mean age of 7.2 years and a standard deviation of 4.95 years. The 2 most common procedures done were craniotomy for trauma and ventriculoperitoneal shunt insertion for hydrocephalus. The mean total cost of a neurosurgical procedure was $895.99. Intensive care unit length of stay was found to have a significant influence on the direct cost. The cost of surgery and investigation were the main contributors to the total cost of care with a mean of $618.3 and a standard deviation of $248.67.

Conclusions: The mean cost of pediatric neurosurgical procedures in our setting is $895.99, which is 40.18% of our gross domestic product per capita. The main drivers of cost are the cost of operation, investigations, and intensive care unit length of stay.

Keywords: Direct cost; Indirect cost; Neurosurgery; Pediatric.

MeSH terms

  • Adolescent
  • Brain Injuries, Traumatic / economics
  • Brain Injuries, Traumatic / surgery
  • Child
  • Child, Preschool
  • Cost of Illness
  • Costs and Cost Analysis
  • Craniotomy / economics
  • Craniotomy / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units / economics
  • Length of Stay
  • Male
  • Neurosurgery / economics*
  • Neurosurgical Procedures / economics*
  • Nigeria
  • Pediatrics / economics*
  • Ventriculoperitoneal Shunt / economics