Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital)
| dc.contributor.author | Kevany, Sebastian | |
| dc.contributor.author | Meintjes, Graeme | |
| dc.contributor.author | Rebe, Kevin | |
| dc.contributor.author | Maartens, Gary | |
| dc.contributor.author | Cleary, Susan | |
| dc.date.accessioned | 2016-03-18T14:06:08Z | |
| dc.date.available | 2016-03-18T14:06:08Z | |
| dc.date.issued | 2009 | |
| dc.date.updated | 2016-01-07T09:55:37Z | |
| dc.description.abstract | Background: Antiretroviral therapy (ART) is being extended across South Africa. While efforts have been made to assess the costs of providing ART via accredited service points, little information is available on its downstream costs, particularly in public secondary level hospitals. Objectives: To determine the cost of care for inpatients and outpatients at a dedicated antiretroviral referral unit treating and caring for antiretroviral-related conditions in a South African peri-urban setting; to identify key epidemiological cost drivers; and to examine the associated clinical and outcome data. Methods: A prospective costing study on 48 outpatients and 25 inpatients was conducted from a health system perspective. Incremental economic costs and clinical data were collected from primary sources at G F Jooste Hospital, Cape Town, over a 1-month period (March 2005). Results: Incremental cost per outpatient was R1 280, and per inpatient R5 802. Costs were dominated by medical staff costs (62% inpatient and 58% outpatient, respectively). Infections predominated among diagnoses and costs – 55% and 67% respectively for inpatients, and 49% and 54% respectively for outpatients. Most inpatients and outpatients were judged by attending physicians to have improved or stabilised as a result of treatment (52% and 59% respectively). Conclusions. The costs of providing secondary level care for patients on or immediately preceding ART initiation can be significant and should be included in the government’s strategic planning: (i) so that the service can be expanded to meet current and future needs; and (ii) to avoid crowding out other secondary level health services. | en_ZA |
| dc.identifier.apacitation | Kevany, S., Meintjes, G., Rebe, K., Maartens, G., & Cleary, S. (2009). Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital). <i>South African Medical Journal</i>, http://hdl.handle.net/11427/18007 | en_ZA |
| dc.identifier.chicagocitation | Kevany, Sebastian, Graeme Meintjes, Kevin Rebe, Gary Maartens, and Susan Cleary "Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital)." <i>South African Medical Journal</i> (2009) http://hdl.handle.net/11427/18007 | en_ZA |
| dc.identifier.citation | Kevany, S., Meintjes, G., Rebe, K., Maartens, G., & Cleary, S. (2009). Clinical and Financial Burdens of Secondary Level Care in a Public Sector Antiretroviral Roll-Out Setting: GF Jooste Hospital. South African Medical Journal, 99(5), 320. | en_ZA |
| dc.identifier.issn | 2413-3108 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Kevany, Sebastian AU - Meintjes, Graeme AU - Rebe, Kevin AU - Maartens, Gary AU - Cleary, Susan AB - Background: Antiretroviral therapy (ART) is being extended across South Africa. While efforts have been made to assess the costs of providing ART via accredited service points, little information is available on its downstream costs, particularly in public secondary level hospitals. Objectives: To determine the cost of care for inpatients and outpatients at a dedicated antiretroviral referral unit treating and caring for antiretroviral-related conditions in a South African peri-urban setting; to identify key epidemiological cost drivers; and to examine the associated clinical and outcome data. Methods: A prospective costing study on 48 outpatients and 25 inpatients was conducted from a health system perspective. Incremental economic costs and clinical data were collected from primary sources at G F Jooste Hospital, Cape Town, over a 1-month period (March 2005). Results: Incremental cost per outpatient was R1 280, and per inpatient R5 802. Costs were dominated by medical staff costs (62% inpatient and 58% outpatient, respectively). Infections predominated among diagnoses and costs – 55% and 67% respectively for inpatients, and 49% and 54% respectively for outpatients. Most inpatients and outpatients were judged by attending physicians to have improved or stabilised as a result of treatment (52% and 59% respectively). Conclusions. The costs of providing secondary level care for patients on or immediately preceding ART initiation can be significant and should be included in the government’s strategic planning: (i) so that the service can be expanded to meet current and future needs; and (ii) to avoid crowding out other secondary level health services. DA - 2009 DB - OpenUCT DO - 10.7196/SAMJ.2978 DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 SM - 2413-3108 T1 - Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital) TI - Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital) UR - http://hdl.handle.net/11427/18007 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/18007 | |
| dc.identifier.uri | http://dx.doi.org/10.7196/SAMJ.2978 | |
| dc.identifier.vancouvercitation | Kevany S, Meintjes G, Rebe K, Maartens G, Cleary S. Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital). South African Medical Journal. 2009; http://hdl.handle.net/11427/18007. | en_ZA |
| dc.language | eng | en_ZA |
| dc.publisher | Academy of Science of South Africa | en_ZA |
| dc.publisher.department | Health Economics Unit | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights | Creative Commons Attribution 4.0 International (CC BY 4.0) | * |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_ZA |
| dc.source | South African Medical Journal | en_ZA |
| dc.source.uri | http://reference.sabinet.co.za/sa_epublication/m_samj | |
| dc.title | Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G F Jooste Hospital) | en_ZA |
| dc.type | Journal Article | en_ZA |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |