Since 1995, trauma and other injuries have been the leading cause of admissions to government hospitals in Sri Lanka. Road traffic injuries and home accidents represent a major fraction. The economic burden of trauma has been in the upswing; for 2005, the estimated hospitalisation and other costs of accidents amounted to 14.166 billion rupees.

Recognising that the onset and deterioration of most accidents can be prevented, the government and its partners have taken vital steps towards safety promotion, improving people’s access to emergency medical services (EMS) and enhancing the quality of hospital care for trauma victims. Their shared vision is the provision of timely, appropriate, quality and cost-effective medical care to trauma victims by a coordinated, sustainable trauma system with improved preparedness.

The introduction of a trauma surveillance system in the Colombo South Teaching Hospital, General Hospital Kalutara, Base Hospital Horana and Base Hospital Panadura demonstrated the operational challenges in generating and using information for trauma prevention, better patient management and policy formulation.

During the next two years, the objective is to strengthen all the components of the trauma system such that safe community programmes will be initiated, the reach of the existing EMS system and the coverage of the trauma surveillance will be expanded, a system for improving the quality of acute and long-term care will be established and a national policy on trauma will be adopted. Central to the achievement of these objective and outputs is a fully functional Trauma Directorate that will ensure the sustainability of the MoH initiatives on trauma and will be a concrete manifestation of the government’s commitment to reducing the growing trauma burden.

Economic Burden of Trauma

The economic burden of trauma and other injuries has been in the upswing as shown by two independent studies (Figure 5- 4). For the year 2005, the total cost was estimated to be 14.166 billion rupees.

A study carried out in 1992 at the Colombo South Teaching Hospital 3 revealed that the average cost per day of hospitalization was Rs. 290 per patient. Of the total treatment cost, 30.11% was on drugs and dressings while 25.85% accounted for the accident service staff salaries. The highest cost was incurred for treating pedestrian victims. A Study 4 in 2001, which was conducted at the General Hospital Kandy and the Teaching Hospital Peradeniya, showed that the average cost per day for hospitalizing a patient was Rs. 3,415.55. These figures illustrate the startling increase in the cost of injuries at an individual level.

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