The Initial Economic Burden of Femur Fractures on Informal Caregivers in Dar es Salaam, Tanzania

Ericka P. von Kaeppler 1 , Erik J. Kramer 2, Claire A. Donnelley 1, Hao-Hua Wu 1, Elliot Marseille 4, Edmund Eliezer 5, Heather J. Roberts 1, David Shearer 1*, Saam Morshed

  1. Institute of Global Orthopaedics and Traumatology at the University of California San Francisco,
  2. Yale University School of Medicine,
  3. Health Strategies International,
  4. Global Health Economics Consortium at the University of California San Francisco,
  5. Muhimbili Orthopaedic Institute

Correspondence: David Shearer (


Femur fracture patients require significant in-hospital care. The burden incurred by caregivers of such patients amplifies the direct costs of these injuries and remains unquantified.
Here we aim to establish the in-hospital economic burden faced by informal caregivers of femur fracture patients.
Methods: 70 unique caregivers for 46 femoral shaft fracture patients were interviewed. Incurred economic burden was determined by the Human Capital Approach, using standardized income data to quantify productivity loss (in $USD). Linear regression assessed the relationship between caregiver burden and patient time-in-hospital.
The average economic burden incurred was $149, 9% of a caregiver’s annual income and positively correlated with patient time in hospital (p<0.01).
Caregivers of patients treated operatively for femur fractures lost a large portion of their annual income, and this loss increased with patient time in hospital. These indirect costs of femur fracture treatment constitute an important component of the total injury burden.
Keywords: Orthopaedic trauma; informal caregivers; economic burden; femur fracture; Tanzania

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