The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa

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dc.contributor.advisorJoubert, Ivan
dc.contributor.advisorCunnama, Lucy
dc.contributor.advisorPeters, Shrikant
dc.contributor.authorHood, Kirsten
dc.date.accessioned2025-02-17T11:30:49Z
dc.date.available2025-02-17T11:30:49Z
dc.date.issued2024
dc.date.updated2025-02-17T11:26:27Z
dc.description.abstractBackground: The expansion of Groote Schuur Hospital's (GSH) Intensive Care Unit (ICU) capacity to accommodate an unprecedented number of patients during the COVID-19 pandemic was an expensive undertaking. There are currently no published formal retrospective analyses of the financial costs of running and expanding COVID-ICUs in South Africa. Objectives: To conduct a cost analysis of the COVID-ICU service at a tertiary state hospital in Cape Town, South Africa. This analysis included the cost of COVID-ICU admissions relating to the first four COVID waves. Aims were to estimate total costs, in-patient day costs, and cost drivers for COVID-ICU. Methods: A retrospective cost analysis (quantitative observational study) using a mixed methods costing approach, was conducted across the COVID-ICUs at GSH. The data used included two consecutive hospital financial years, between April 2020 and March 2022. Costs were calculated monthly and then combined to achieve a total cost over the two-year period. COVID-ICU in-patient days were used as the primary allocation factor. Cost inputs included recurrent costs such as human resources, diagnostics, pharmaceuticals, oxygen, enteral feeds, blood products, consumables, and overheads, as well as capital costs including equipment, and building space. Results: The study period covered the four COVID waves that affected GSH ICU units between April 2020 and March 2022. This period included 10 497 COVID-ICU in-patient days resulting from a total of 776 COVID-ICU admissions. The total calculated spending across the two financial years was R262 482 904, resulting in a cost per in-patient day of R25 006, and a utilisation of 4,4% of the total hospital budget during the same period. The median length of stay was nine days, resulting in a median cost per admission of R225 050. The top five cost drivers were human resources (60%), consumables (9%), pharmaceuticals (8%), oxygen (5%), and overheads (5%). Conclusion: This is a retrospective costing study of the COVID-ICUs at a tertiary hospital in Cape Town, throughout the entire portion of the pandemic that required ICU admissions in South Africa. This analysis provides useful financial insights, a potential economic model for ICU budgeting, and creates a platform for future economic analyses and policy planning regarding level-of-care decisions for general ICU admissions or for similar future pandemics within the South African and LMIC hospital setting.
dc.identifier.apacitationHood, K. (2024). <i>The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/40979en_ZA
dc.identifier.chicagocitationHood, Kirsten. <i>"The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2024. http://hdl.handle.net/11427/40979en_ZA
dc.identifier.citationHood, K. 2024. The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/40979en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Hood, Kirsten AB - Background: The expansion of Groote Schuur Hospital's (GSH) Intensive Care Unit (ICU) capacity to accommodate an unprecedented number of patients during the COVID-19 pandemic was an expensive undertaking. There are currently no published formal retrospective analyses of the financial costs of running and expanding COVID-ICUs in South Africa. Objectives: To conduct a cost analysis of the COVID-ICU service at a tertiary state hospital in Cape Town, South Africa. This analysis included the cost of COVID-ICU admissions relating to the first four COVID waves. Aims were to estimate total costs, in-patient day costs, and cost drivers for COVID-ICU. Methods: A retrospective cost analysis (quantitative observational study) using a mixed methods costing approach, was conducted across the COVID-ICUs at GSH. The data used included two consecutive hospital financial years, between April 2020 and March 2022. Costs were calculated monthly and then combined to achieve a total cost over the two-year period. COVID-ICU in-patient days were used as the primary allocation factor. Cost inputs included recurrent costs such as human resources, diagnostics, pharmaceuticals, oxygen, enteral feeds, blood products, consumables, and overheads, as well as capital costs including equipment, and building space. Results: The study period covered the four COVID waves that affected GSH ICU units between April 2020 and March 2022. This period included 10 497 COVID-ICU in-patient days resulting from a total of 776 COVID-ICU admissions. The total calculated spending across the two financial years was R262 482 904, resulting in a cost per in-patient day of R25 006, and a utilisation of 4,4% of the total hospital budget during the same period. The median length of stay was nine days, resulting in a median cost per admission of R225 050. The top five cost drivers were human resources (60%), consumables (9%), pharmaceuticals (8%), oxygen (5%), and overheads (5%). Conclusion: This is a retrospective costing study of the COVID-ICUs at a tertiary hospital in Cape Town, throughout the entire portion of the pandemic that required ICU admissions in South Africa. This analysis provides useful financial insights, a potential economic model for ICU budgeting, and creates a platform for future economic analyses and policy planning regarding level-of-care decisions for general ICU admissions or for similar future pandemics within the South African and LMIC hospital setting. DA - 2024 DB - OpenUCT DP - University of Cape Town KW - Groote Schuur Hospital KW - GSH KW - Intensive Care Unit KW - ICU KW - COVID-19 pandemic KW - COVID-ICUs KW - South Africa KW - LMIC hospital LK - https://open.uct.ac.za PY - 2024 T1 - The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa TI - The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa UR - http://hdl.handle.net/11427/40979 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/40979
dc.identifier.vancouvercitationHood K. The costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2024 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/40979en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectGroote Schuur Hospital
dc.subjectGSH
dc.subjectIntensive Care Unit
dc.subjectICU
dc.subjectCOVID-19 pandemic
dc.subjectCOVID-ICUs
dc.subjectSouth Africa
dc.subjectLMIC hospital
dc.titleThe costing of COVID-19 intensive care units at a tertiary hospital in Cape Town, South Africa
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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