Evaluating the Socioeconomic Impact on Critical Care Delivery in Low- and Middle-Income Countries: A Prospective Observational Study From Nigeria

Abstract

OBJECTIVES: – To examine the financial burden of critical care (CC), primary cost drivers, and clinical outcomes associated with CC delivery in low- and middle-income countries (LMICs). PERSPECTIVE: – CC accounts for a significant cost of global health expenditure. LMICs, where the burden of critical illness is high and access remains inequitable, data on CC’s financial impact are scarce, undermining efforts to strengthen capacity, optimize delivery, and guide resource allocation. SETTING: – ICU at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Tertiary Hospital in Nigeria. METHODS: – An observational cross-sectional study was conducted. Patients were recruited via a convenient sampling method. Data were collected within the first 24 hours of admission. RESULTS: – A total of 96 patients were analyzed. The average daily cost of a CC bed was ₦4, 780.49 (U.S. dollar [USD] 2.99) without mechanical ventilation (MV) and ₦21, 255.56 (USD 13.28) with MV. The mean expenditure within the first 24 hours of admission was ₦144, 928.00 (USD 90.58). The mortality rate was 23.96%, with higher ASA scores (III and IV) and age over 40 years associated with increased costs and poorer outcomes. Higher CC costs and lower household income are strongly associated with increased mortality. CONCLUSIONS: – The financial burden of CC far exceeds Nigeria’s monthly minimum wage of ₦70, 000.00 (USD 43.75), highlighting the urgent need for health policy and resource allocation strategies to improve timely and equitable CC outcomes in LMICs.