Objective: Little is known about the costs of injury and their impact on injured persons and their families
in Vietnam. This study aimed to examine the cost of injury in hospitalised patients and to identify the
most costly injuries and those more likely to result in catastrophic household expenditure.
Method: A prospective cohort study was conducted, recruiting individuals admitted to Thai Binh General
Hospital due to injury in Vietnam from January to August 2010. During the hospitalisation period, data on
expenditure including direct medical, direct non-medical and indirect costs were collected. Demographic
and injury characteristics were also obtained. The associations between the risk of catastrophic
expenditure and injury cause, severity and principal injured region were examined by modified Poisson
regression approach. Payment of more than 40% of the household non-subsistence spending was
considered a catastrophic expenditure.
Results: Of 918 patients approached, 892 (97%) were recruited. Total costs for all participants during the
hospitalisation period were US$ 325,812. Patients admitted for road injury accounted for the largest
number of injuries (n = 477, 53%), and the largest percentage of the total costs (US$ 175,044, 57%). This
was followed by individuals hospitalised due to falls, representing 29% of the sample (n = 261) and 31% of
the total costs (US$ 103,128). In terms of cost per hospital stay, burn injuries were the most costly (US$
427), followed by falls (US$ 395) and road crashes (US$ 367). Of all sample, 26% experienced catastrophic
expenditure due to their injuries. Factors significantly associated with increased risk of catastrophic
expenditure were having more severe or higher MAIS injuries (RR = 2.02, 95% CI: 1.14–3.57), principal
injured region to lower extremities (RR = 3.34, 95% CI: 1.41–7.91) or head (RR = 3.21, 95% CI: 1.37–7.52),
longer hospital stay (RR = 1.09, 95% CI: 1.07–1.10), older age, lower income and not having insurance
(RR = 1.63, 95% CI: 1.21–2.21).
Conclusion: A high proportion of households experienced catastrophic expenditure following injury,
highlighting the important need for programmes to prevent injuries, road traffic and fall-related injuries
in particular. Furthermore, expansion of health insurance coverage may help individuals cope with the
financial consequences of injury.