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Renal dialysis in Barbados - part 1: cost of dialysis provision at the Queen Elizabeth Hospital
Adomakoh, S. A; Adi, C; Nicholson, George D; Fraser, Henry S.
Afiliação
  • Adomakoh, S. A; University of the West Indies, Cave Hill, Barbados. Department of Medicine
  • Adi, C; Queen Elizabeth Hospital, Barbados
  • Nicholson, George D; University of the West Indies, Cave Hill, Barbados. Department of Medicine
  • Fraser, Henry S; University of the West Indies, Cave Hill, Barbados. Department of Medicine
West Indian med. j ; 49(Suppl 2): 20, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-1001
Biblioteca responsável: JM3.1
Localização: JM3.1; R18.W4
ABSTRACT

OBJECTIVE:

The purpose of this study was to assess the health service cost of haemodialysis delivered by the Queen Elizabeth Hospital, Barbados. DESIGN AND

METHODS:

A cost analysis was performed from the viewpoint of the study hospital using the treatment protocols based on current practice. These incorporated procedures to establish dialysis access sites (surgical set up) and dialysis maintenance. Cost and patient data were collected for the period April 1, 1998 to March 31, 1999. Sixty-four patients were studied. Analyzed costs included personnel, drug expenditure, supplies (dialysis and non-dialysis related), inpatient costs, laboratory and other ancillary services, and indirect or overhead costs such as plant, housekeeping, laundry and administration.

RESULTS:

The final cost per patient year was $37,930.04 in the first year of dialysis and included surgical set-up, and $34,059.08 in the subsequent years (excluding inpatient admissions and treatments for complications). The total cost of dialysis provision for the year excluding surgical set up was $2,178,561.09. The cost per visit was estimated to be $286.95. Direct costs (determined by patient utilization and physician and nurse directives) amounted to 81.8 percent of total cost. The main expenditure sections were dialysis-related supplies, labour and overheads. Cost savings incurred as a result of strict modification of treatment guidelines were estimated. By altering the number of dialysis visits per week and introducing other cost saving measures, such as dialyzer re-use, a savings of $852,176.32 was observed with a full potential savings of $902,218.63. An incremental cost analysis of a service expansion (scenario 1) indicated that the cost savings would be sufficient to provide an additional 3,328 dialysis treatments or visits per year, incorporating 4 additional dialysis machines.

CONCLUSIONS:

These findings are important in the light of constrained economic resources. However, the outcomes associated with the observed costs must be explored in order to assess the "true value" or cost effectiveness of the current dialysis practice. Therefore, this analysis is but one component of an overall study to review the renal dialysis services in Barbados for the purpose of informing plans for expansion and optimization of services.(Au)
Assuntos
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Coleções: Bases de dados internacionais Contexto em Saúde: Agenda de Saúde Sustentável para as Américas Problema de saúde: Objetivo 4: Financiamento para a saúde Base de dados: MedCarib Assunto principal: Custos e Análise de Custo / Unidades Hospitalares de Hemodiálise Tipo de estudo: Guia de prática clínica / Avaliação econômica em saúde Limite: Humanos País/Região como assunto: Barbados / Caribe Inglês Idioma: Inglês Revista: West Indian med. j Ano de publicação: 2000 Tipo de documento: Artigo
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Coleções: Bases de dados internacionais Contexto em Saúde: Agenda de Saúde Sustentável para as Américas Problema de saúde: Objetivo 4: Financiamento para a saúde Base de dados: MedCarib Assunto principal: Custos e Análise de Custo / Unidades Hospitalares de Hemodiálise Tipo de estudo: Guia de prática clínica / Avaliação econômica em saúde Limite: Humanos País/Região como assunto: Barbados / Caribe Inglês Idioma: Inglês Revista: West Indian med. j Ano de publicação: 2000 Tipo de documento: Artigo
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