Cost of childhood severe pneumonia management in selected public inpatient care facilities in Bangladesh: a provider perspective.
Arch Dis Child
; 109(8): 622-627, 2024 Jul 18.
Article
in En
| MEDLINE
| ID: mdl-38621857
ABSTRACT
OBJECTIVE:
To estimate inpatient care costs of childhood severe pneumonia and its urban-rural cost variation, and to predict cost drivers.DESIGN:
The study was nested within a cluster randomised trial of childhood severe pneumonia management. Cost per episode of severe pneumonia was estimated from a healthcare provider perspective for children who received care from public inpatient facilities. A bottom-up micro-costing approach was applied and data collected using structured questionnaire and review of the patient record. Multivariate regression analysis determined cost predictors and sensitivity analysis explored robustness of cost parameters.SETTING:
Eight public inpatient care facilities from two districts of Bangladesh covering urban and rural areas. PATIENTS Children aged 2-59 months with WHO-classified severe pneumonia.RESULTS:
Data on 1252 enrolled children were analysed; 795 (64%) were male, 787 (63%) were infants and 59% from urban areas. Average length of stay (LoS) was 4.8 days (SD ±2.5) and mean cost per patient was US$48 (95% CI US$46, US$49). Mean cost per patient was significantly greater for urban tertiary-level facilities compared with rural primary-secondary facilities (mean difference US$43; 95% CI US$40, US$45). No cost variation was found relative to age, sex, malnutrition or hypoxaemia. Type of facility was the most important cost predictor. LoS and personnel costs were the most sensitive cost parameters.CONCLUSION:
Healthcare provider cost of childhood severe pneumonia was substantial for urban located public health facilities that provided tertiary-level care. Thus, treatment availability at a lower-level facility at a rural location may help to reduce overall treatment costs.Key words
Full text:
1
Collection:
01-internacional
Health context:
1_ASSA2030
/
4_TD
Database:
MEDLINE
Main subject:
Pneumonia
/
Length of Stay
Limits:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Arch Dis Child
Year:
2024
Document type:
Article