Browsing by Subject "Cost analysis"

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    Health system costs of rheumatic heart disease care in South Africa
    (2021-07-03) Hellebo, Assegid G.; Zuhlke, Liesl J.; Watkins, David A.; Alaba, Olufunke
    Background Rheumatic Heart Disease (RHD) is a disease of poverty that is neglected in developing countries, including South Africa. Lack of adequate evidence regarding the cost of RHD care has hindered national and international actions to prevent RHD related deaths. The objective of this study was to estimate the cost of RHD-related health services in a tertiary hospital in the Western Cape, South Africa. Methods The primary data on service utilisation were collected from a randomly selected sample of 100 patient medical records from the Global Rheumatic Heart Disease Registry (the REMEDY study) - a registry of individuals living with RHD. Patient-level clinical data, including, prices and quantities of medications and laboratory tests, were collected from the main tertiary hospital providing RHD care. All annual costs from a health system perspective were estimated in 2017 (base year) in South African Rand (ZAR) using a combination of ingredients and step-down costing approaches and later converted to United States dollars (USD). Step-down costing was used to estimate provider time costs and all other facility costs such as overheads. A 3% discount rate was also employed in order to allow depreciation and opportunity cost. We aggregated data to estimate the total annual costs and the average annual per-patient cost of RHD and conducted a one-way sensitivity analysis. Results The estimated total cost of RHD care at the tertiary hospital was USD 2 million (in 2017 USD) for the year 2017, with surgery costs accounting for 65%. Per-patient, average annual costs were USD 3900. For the subset of costs estimated using the ingredients approach, outpatient medications, and consumables related to cardiac catheterisation and heart valve surgery were the main cost drivers. Conclusions RHD-related healthcare consumes significant tertiary hospital resources in South Africa, with annual per-patient costs higher than many other non-communicable and infectious diseases. This analysis supports the scaling up of primary and secondary prevention programmes at primary health centers in order to reduce future tertiary care costs. The study could also inform resource allocation efforts and provide cost estimates for future studies of intervention cost-effectiveness.
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    Open Access
    Parenting for lifelong health programme for parents and teens in Botswana: cost estimation and the budget impact analysis
    (2025) Ntuli, Musa; Sinanovic, Edina
    Background: Given all its detrimental effects, child abuse is one of the biggest public health issues. Depression, suicidal thoughts, risky sexual behaviour, and substance abuse are a few examples of these effects. The random control trial was conducted in 25 nations with low to middle incomes, including Botswana. The goal of the PLH SUPER study is to address and stop child abuse in environments with limited resources. The overall and unit costs of the PLH program and the BIA, should it expand to national levels, were estimated by this PLH SUPER sub-study. Methodology: Micro-cost analysis was performed from April 2021 until March 2022, taking the provider perspective to make a computation on the total and unit costs of enrolling families in the PLH program. The target population of the teenagers of age 10–17 and their guardians were the aimed group in Botswana, and the BIA was subsequently determined through the unit cost per family enrolled. Results: The results exposed variation in every PLH program implementation cost across centres, from US $22,771.96 in Goodhope, to US $60,662.82 in Gaborone. The unit cost per enrolled family ranged from US $168.68 in Goodhope, to US $336.91 Letlhakane. Personnel costs accounted for 64% of total expenditure. The PLH enrolment coverage projected at 5.7% and 40,525 families identified as the programs target population for national scale-up. The cost per family enrolled in the PLH program ranged from US $168.68 to US $336.91, per family. Therefore, the total budget needed for expanding the PLH program varies from US $6,835,788.61 to US $13,653,186.67 Conclusion: This study investigated the cost implication of nationally scaling-up PLH interventions in Botswana. The findings of this study present the decision makers with guidance on the possible costs that could be incurred in scaling-up the PLH interventions countrywide. Furthermore, the study also guides policy makers on how the national scale-up could impact the existing health and wealth budget. This study immensely contributes on the global discourse on prevention of maltreatment. Lastly, Cost Effectives Analysis study for rolling out PLH interventions in Botswana is highly recommended.