Department of Health Policy and Management, Institute of health, Jimma University, Jimma, Ethiopia.
Department of Pediatrics and Child Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Ethiop J Health Sci. 2022 Jul;32(4):765-772. doi: 10.4314/ejhs.v32i4.13.
Infections of the central nervous system (CNS) such as meningitis or encephalitis can be caused by myriad of microorganisms and may be life-threatening. In Ethiopia, it is an important cause of premature death and disability, being the 9 most common cause of years of life lost and loss of disability-adjusted life years.The objective of this study was to estimate the cost of suspected and confirmed bacterial meningitis among inpatient managed patients at JUMC.
A facility-based cross-sectional study was conducted from July 28 to September 12, 2018. A semi-structured questionnaire was used in this study. Checklists were used to collect the types of laboratory tests performed and prescribed medications. This cost of illness study was conducted from the patient perspectives. We employed a micro-costing bottom-up approach to estimate the direct cost of meningitis. The human capital approach was used for estimating wages lost.
Among total patients admitted and treated in JUMC, higher proportions (69.8%) were suspected bacterial meningitis but have been treated as confirmed cases. Total median costs for both suspected and confirmed bacterial meningitis patients were estimated to be ETB 98,812.32 (US $ 3,593.2; IQR 1,303.0 to 5,734.0). Total median direct cost was ETB 79,248.02 (US $ 2,881.75; IQR 890.7 to 3,576.7). Moreover, 45.3% of the patients reported that they were either admitted or given medication at JUMC or nearby health facility before their current admissions.
These findings indicate that most cases of bacterial meningitis were treated only empirically, and the cost of the treatment was high, especially for resource-limited countries like Ethiopia. To minimize the burden of meningitis and avoid unnecessary hospitalizations, the availability of diagnostic techniques is vitally important.
中枢神经系统(CNS)感染,如脑膜炎或脑炎,可由多种微生物引起,可能危及生命。在埃塞俄比亚,它是导致过早死亡和残疾的一个重要原因,是导致丧失生命年和丧失残疾调整生命年的第 9 大常见原因。本研究旨在估计朱巴教学与 referral 医院(JUMC)住院患者疑似和确诊细菌性脑膜炎的成本。
本研究为 2018 年 7 月 28 日至 9 月 12 日进行的基于机构的横断面研究。本研究采用半结构式问卷。检查表用于收集进行的实验室检查类型和规定的药物。本疾病成本研究从患者角度进行。我们采用微观成本自上而下的方法来估计脑膜炎的直接成本。人力资本法用于估计工资损失。
在 JUMC 住院和治疗的患者中,较高比例(69.8%)被怀疑为细菌性脑膜炎,但已作为确诊病例进行治疗。疑似和确诊细菌性脑膜炎患者的总中位数成本估计为 98812.32 比尔(3593.2 美元;IQR 1303.0 至 5734.0)。总中位数直接成本为 79248.02 比尔(2881.75 美元;IQR 890.7 至 3576.7)。此外,45.3%的患者报告称,他们在目前入院前,要么在 JUMC 或附近的卫生机构入院,要么接受了药物治疗。
这些发现表明,大多数细菌性脑膜炎病例仅经验性治疗,治疗费用高昂,尤其是对于埃塞俄比亚等资源有限的国家。为了最大限度地减轻脑膜炎的负担并避免不必要的住院治疗,诊断技术的可用性至关重要。