Hansen K, Chapman G, Chitsike I, Kasilo O, Mwaluko G
Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
Health Policy Plan. 2000 Dec;15(4):432-40. doi: 10.1093/heapol/15.4.432.
According to official figures, HIV infection in Zimbabwe stood at 700 000-1 000 000 in 1995, representing 7-10% of the population, with even higher expected numbers in 2000. Such high numbers will have far reaching effects on the economy and the health care sector. Information on costs of treatment and care of HIV/AIDS patients in health facilities is necessary in order to have an idea of the likely costs of the increasing number of HIV/AIDS patients. Therefore, the present study estimated the costs per in-patient day as well as per in-patient stay for patients in government health facilities in Zimbabwe with special emphasis on HIV/AIDS patients. Data collection and costing was done in seven hospitals representing various levels of the referral system. The costs per in-patient day and per in-patient stay were estimated through a combination of two methods: bottom-up costing methodology (through an in-patient note review) to identify the direct treatment and diagnostic costs such as medication, laboratory tests and X-rays, and the standard step-down costing methodology to capture all the remaining resources used such as hospital administration, meals, housekeeping, laundry, etc. The findings of the study indicate that hospital care for HIV/AIDS patients was considerably higher than for non-HIV/AIDS patients. In five of the seven hospitals visited, the average costs of an in-patient stay for an HIV/AIDS patient were found to be as much as twice as high as a non-HIV/AIDS patient. This difference could be attributed to higher direct costs per in-patient day (medication, laboratory tests and X-rays) as well as longer average lengths of stay in hospital for HIV/AIDS patients compared with non-infected patients. Therefore, the impact on hospital services of increasing number of HIV/AIDS patients will be enormous.
根据官方数据，1995年津巴布韦的艾滋病毒感染人数为70万至100万，占人口的7%至10%，预计2000年这一数字会更高。如此高的感染人数将对经济和医疗保健部门产生深远影响。了解医疗机构中艾滋病毒/艾滋病患者的治疗和护理成本信息，对于预估不断增加的艾滋病毒/艾滋病患者可能带来的成本很有必要。因此，本研究估算了津巴布韦政府医疗机构中每位住院患者每天以及每次住院的费用，特别关注了艾滋病毒/艾滋病患者。数据收集和成本核算在代表不同转诊级别的七家医院进行。每位住院患者每天以及每次住院的费用通过两种方法相结合来估算：自下而上的成本核算方法（通过审查住院记录）来确定直接治疗和诊断成本，如药物、实验室检查和X光检查，以及标准的逐步递减成本核算方法来计算所使用的所有其他资源，如医院管理、膳食、家政、洗衣等。研究结果表明，艾滋病毒/艾滋病患者的住院护理费用比非艾滋病毒/艾滋病患者高得多。在所走访的七家医院中的五家，发现艾滋病毒/艾滋病患者的平均住院费用高达非艾滋病毒/艾滋病患者的两倍。这种差异可能归因于每位住院患者每天的直接成本（药物、实验室检查和X光检查）较高，以及与未感染患者相比，艾滋病毒/艾滋病患者的平均住院时间更长。因此，艾滋病毒/艾滋病患者数量的增加对医院服务的影响将是巨大的。
