Multiple Burdens of Road Traffic Crashes in Pokhara, Nepal: A Patient Approach

Background The economic burden and cost-related evidence from primary data of road traffic crashes (RTCs) in Nepal are limited. Aim This study assessed the disability-adjusted life years (DALYs), the cost associated with RTCs, and socio-demographic and injury related factors. Methods We 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. Results More 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 victim’s indirect cost. Conclusion The 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. Victim’s indirect cost is increased with DALYs, suggesting a policy implication. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was granted from Institutional Review Committee (IRC) of Pokhara University Research Center (PURC), Kaski, Nepal. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.