Evaluating the Socioeconomic Impact on Critical Care Delivery in Resource-Limited Countries

Introduction: Critical care (CC) significantly contributes to global healthcare expenditures, particularly in low-resource countries (LRCs), where access remains limited. Despite its importance, data on the economic burden and outcomes of CC in LRCs are scarce. This study aims to evaluate the direct costs, key cost drivers, and clinical outcomes associated with critical care in a tertiary hospital in Nigeria, and to assess the socioeconomic impact on patients in an LRC setting.


Methods: This prospective observational study in a tertiary hospital in Nigeria included adult patients (≥18 years) admitted to the CC unit between May and October 2024. Data on demographics, primary diagnoses, cost of care and outcomes within the first 24 hours were collected. Statistical analyses, including Pearson’s correlation and Chi-square tests, were used.


Results: A total of 96 patients were enrolled (38.5% male, 61.5% female), with a mean age of 33 years. The average daily cost of a CC bed was ₦4,780.49 ($2.98) without mechanical ventilation and ₦21,255.56 ($13.28) with ventilation. Mean daily costs for imaging, medications, and ancillary services were ₦55,523.33 ($34.70), ₦50,450.00 ($31.53), and ₦18,153.85 ($11.35), respectively. The mean cost of care in the first 24 hours was ₦144,928.00 ($90.58), and the total mean cost at discharge was ₦388,592.74 ($242.87). The overall mortality rate was 23.96%. Higher ASA scores (3 & 4) and patient age (over 40 years were significantly associated with increased costs and poorer outcomes (p < 0.05).


Conclusions: Mechanical ventilation, imaging, and drugs were identified as the primary cost drivers in critical care delivery in Nigeria. Higher ASA scores and age are significantly associated with increased costs and poorer outcomes. The financial burden of critical care far exceeds the national monthly minimum wage of ₦70,000.00 ($43.75), creating a substantial barrier to timely and equitable access to care. In low-resource settings, this economic strain limits the availability of CC services and exacerbates health disparities, underscoring the need for systemic investment in CC infrastructure to improve accessibility and outcomes.