Cost of hospital care for HIV/AIDS infected patients in three general reference hospitals in Lubumbashi, DR Congo: prospective cohort study

• Published in: The Pan African medical journal Vol. 15; no. 76; p. 76
• Main Authors: Tshamba, Henri Mundongo, a Kaut, Clarence Mukeng, Kyalubile, Nono Mulubwa, Kakambal, Alphonse Kaij, Yav, Grevisse Ditend, Kaj, Françoise Malonga, Vancaillie, Didier
• Format: Journal Article Web Resource
• Language: English
• Published: Uganda African Field Epidemiology Network 26.06.2013; The African Field Epidemiology Network; The Pan African Medical Journal
• Subjects: Accounting & auditing; Adolescent; Adult; AIDS-Related Opportunistic Infections - economics; AIDS-Related Opportunistic Infections - epidemiology; Anti-Retroviral Agents - economics; Anti-Retroviral Agents - therapeutic use; Business & economic sciences; CD4 Lymphocyte Count; Cohort Studies; Comptabilité & audit; Consommation de soins; Coûts de soins de santé; Democratic Republic of the Congo - epidemiology; Educational Status; Facteurs prédictifs; Female; Healthcare consumption; Healthcare costs; HIV AIDS; HIV Infections - economics; HIV Infections - epidemiology; HIV Sida; Hospital Costs - statistics & numerical data; Hospitals, General; Human health sciences; Humans; Income; Male; Middle Aged; Predictive factors; predictive factors for healthcare consumption; Public health, health care sciences & services; Santé publique, services médicaux & soins de santé; Sciences de la santé humaine; Sciences économiques & de gestion; Young Adult; Democratic Republic of the Congo; Predictive factors for healthcare consumption; Healthcare costs; HIV AIDS
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2013.15.76.2638

This article analyses the composition of healthcare costs for HIV/AIDS infected patients in a country with limited resources and attempts to identify the factors that influence these costs. The aims are to calculate medical care costs, analysing how they vary depending on patients' income, and to evaluate the factors explaining healthcare consumption. This is a prospective cohort study focusing on patients who were admitted to hospital for a short stay between January 2010 and June 2011, before their integration into a specialised program. The patients were selected randomly. Free consent was obtained from all participants. Data were analysed using the SPSS 19.0 software. The significance threshold was set at 5% and the CI (Confidence Interval) at 95%. We used Kruskal-Wallis tests, Fisher's exact test and multiple linear regression. We monitored 209 patients. Their average age was 36.37 years (SD: 8.72). The sex ratio was 0.58 and the women patients were generally younger than the male ones (p=0.011). The overall cost of healthcare amounted to $US 41,922. The cost of Antiretroviral Therapy represented 21.6% ($US 9,045). The price of para-clinical examinations represented 46% ($US 19,136) of the overall cost. The patient's average monthly income was $US 157.40 whereas the average direct cost per patient was$US 201.45. Both monthly income (t=4.385; p=0.0000) and education level (t=3.703 p=0.0003) were statistically significant predictive factors for healthcare consumption. The medical care costs for patients with opportunistic infections were nine times higher than those for patients who presented none. The presence of opportunistic infections increased healthcare consumption by approximately 31$ US (CI 95%: 15-46.9). The average direct cost for patients on each short-term stay was higher than the average monthly income. To be able to access the necessary services, the patients need additional resources, which are derived from various sources. Monthly income and the level of education were both statistically significant predictors for healthcare consumption. The analysis allows us to extend the study by using different analytical accounting approaches such as by case and by pathology.