Cost Burden of Rigid Internal Fixation in Craniomaxillofacial Trauma Care in Low‐ and Middle‐Income Countries
David A. Shaye,
Obinna Nwosu,
Isaie Ncogoza,
Victor Nyabyenda,
Gratien Tuyishimire,
Wayne Manana,
Abdurrazaq Olanrewaju Taiwo
Affiliations
David A. Shaye
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Harvard Medical School Boston Massachusetts USA
Obinna Nwosu
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Harvard Medical School Boston Massachusetts USA
Isaie Ncogoza
Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda
Victor Nyabyenda
Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda
Gratien Tuyishimire
Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda
Wayne Manana
Department of Oral and Maxillofacial Surgery, Faculty of Health Sciences University of Zimbabwe Harare Zimbabwe
Abdurrazaq Olanrewaju Taiwo
Departments of Oral and Maxillofacial Surgery/Dental and Maxillofacial Surgery, Faculty of Dental Sciences Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital Sokoto Nigeria
Abstract Fractures of the craniomaxillofacial (CMF) skeleton cause significant morbidity and mortality in low‐ and middle‐income countries (LMICs). Despite this, quality CMF trauma care is lacking for the majority of the world's population. There is a paucity of literature describing the costs of standard‐of‐care open reduction internal fixation (ORIF) for CMF fractures in LMICs. We consider the cost of a six‐hole plate with six screws (SHPS), standard materials used in ORIF for CMF fractures, as a percentage of gross domestic product (GDP) per capita to ascertain the cost burden to patients. Hospital pricing catalog data at 14 LMIC institutions were queried. On average, the SHPS cost represented 10.2% of the GDP per capita in sampled LMICs. We highlight manufacturing costs, import taxes, and lack of subsidized health care as factors contributing to the significant cost burden of ORIF in these areas. Future work should characterize additional financial and socioeconomic barriers to optimal CMF care.
