Health Care Costs and the Socioeconomic Consequences of Work Injuries in Brazil: A Longitudinal Study

Work injuries are a worldwide public health problem but little is known about theirsocioeconomic impact. This prospective longitudinal study estimates the direct health carecosts and socioeconomic consequences of work injuries for 406 workers identified in theemergency departments of the two largest public hospitals in Salvador, Brazil, from Junethrough September 2005. After hospital discharge workers were followed up monthly untiltheir return to work. Most insured workers were unaware of their rights or of how toobtain insurance benefits (81.6%). Approximately half the cases suffered loss of earnings,and women were more frequently dismissed than men. The most frequently reported familyconsequences were: need for a family member to act as a caregiver and difficulties withdaily expenses. Total costs were US$40,077.00 but individual costs varied widely,according to injury severity. Out-of-pocket costs accounted for the highest proportion oftotal costs (50.5%) and increased with severity (57.6%). Most out-of-pocket costs wererelated to transport and purchasing medicines and other wound care products. The secondlargest contribution (40.6%) came from the public National Health System − SUS. Employerparticipation was negligible. Health care funding must be discussed to alleviate theeconomic burden of work injuries on workers.