Am J Trop Med Hyg. 2014 Jan;90(1):20-32. doi: 10.4269/ajtmh.13-0019. Epub 2013 Nov 11.
There is little evidence on the impact of malaria control on the health system, particularly at the facility level. Using retrospective, longitudinal facility-level and patient record data from two hospitals in Zambia, we report a pre-post comparison of hospital admissions and outpatient visits for malaria and estimated costs incurred for malaria admissions before and after malaria control scale-up. The results show a substantial reduction in inpatient admissions and outpatient visits for malaria at both hospitals after the scale-up, and malaria cases accounted for a smaller proportion of total hospital visits over time. Hospital spending on malaria admissions also decreased. In one hospital, malaria accounted for 11% of total hospital spending before large-scale malaria control compared with < 1% after malaria control. The findings demonstrate that facility-level resources are freed up as malaria is controlled, potentially making these resources available for other diseases and conditions.
关于疟疾控制对卫生系统的影响，尤其是对医疗机构层面的影响，证据有限。本文利用赞比亚两家医院的回顾性、纵向医疗机构层面和患者记录数据，报告了疟疾控制扩大规模前后疟疾住院和门诊就诊情况的前后比较，并估算了疟疾住院的费用。结果表明，疟疾控制扩大规模后，两家医院的疟疾住院和门诊就诊人数都大幅减少，而且随着时间的推移，疟疾病例在总就诊人数中的比例也越来越小。疟疾住院治疗的医院支出也有所减少。一家医院在大规模疟疾控制之前，疟疾占医院总支出的 11%，而疟疾控制之后，这一比例降至<1%。研究结果表明，随着疟疾的控制，医疗机构层面的资源得到了释放，这些资源可能会用于治疗其他疾病和病症。
