Disparity in conference registration cost for delegates from low- and middle-income backgrounds

BACKGROUND: Better access for clinicians from low- and middle-income countries to international conferences can improve collaborative opportunities and subsequently address the knowledge gap between the weaker and stronger knowledge economies. A better understanding of the cost of international conferences may help conference organisers improve access to their conferences. This study aimed to describe the expense-associated barriers to a selection of international emergency medicine and critical care conferences, in terms of registration cost and out-of-pocket expense. METHODS: A cross sectional, retrospective design was used. Registration cost variables (cost, waivers, discounts and scholarships) were collected from a cohort of international emergency medicine and critical care conferences held during 2016. The World Health Organization Purchasing Power Parity index was then applied to calculate an equitable registration cost for delegates from South Africa, Brazil, Turkey, China, Australia, Germany and the United States for each conference. RESULTS: Twenty conferences were included. Eight conferences (36%) offered discounted rates, and another eight offered scholarships for low- and middle-income country delegates. Calculated, equitable registration rates were 2.6, 1.9, 1.9, 1.7, 0.9, 1.1 times lower than quoted respectively for South Africa, Brazil, Turkey, China, Australia and Germany compared to the rate in United States dollar. Only one conference provided equitable registration rates for all test-countries. DISCUSSION: Current international conference registration costs (despite discounts, waivers and scholarships) are likely a barrier to including low- and middle-income delegates in the educational, networking and promotional opportunities that conferences provide. Conference organisers should consider restructuring registration costs to encourage more representative international audiences.