Out-of-pocket expenditure in patients with isolated traumatic brain injury: a two center cohort study, a preliminary report

BACKGROUND: Traumatic brain injuries (TBI) account for 30–40% of global injury mortality. In India, high out-of-pocket expenditure (OOPE; 58.7% of total health costs) exacerbates catastrophic health expenditures (CHE). This study estimates OOPE, along with the risk of CHE and distress financing, in patients with isolated TBI. METHODS: We conducted a prospective cohort study across two centers, enrolling patients with isolated TBI over one month. Direct (medical and non-medical) and indirect (wage loss) costs were recorded using medical diaries. 3 months post discharge rehabilitation expenses were recorded. RESULTS: Eighteen participants (mean age: 43 years, eleven males) were included; four had health insurance, and seven were primary earners. The mean OOPE was INR 88,485 comprising INR 58,319 in direct and INR 30,166 in indirect costs. CHE was observed in fifteen participants and distress financing in eleven participants. CONCLUSION: Despite subsidized care, the substantial OOPE for isolated TBI underscores the financial burden, and the imperative for equitable, sustainable healthcare policies.