Department of Public Health, College of Health Science, Arsi University, Assela, Ethiopia.
Bokoji Primary Hospital, Oromia Health Bureau, Bokoji, Ethiopia.
BMC Health Serv Res. 2023 Sep 4;23(1):948. doi: 10.1186/s12913-023-09988-2.
The coronavirus disease 2019 (Covid-19) pandemic is a global public health problem. The Covid-19 pandemic has had a substantial impact on the economy of developing countries, including Ethiopia.This study aimed to determine the hospitalisation costs of Covid-19 and the factors associated with the high cost of hospitalisation in South Central Ethiopia.
A retrospective cost analysis of Covid-19 patients hospitalised between July 2020 and July 2021 at Bokoji Hospital Covid-19 Treatment Centre was conducted using both the micro-costing and top-down approaches from the health system perspective. This analysis used cost data obtained from administrative reports, the financial reports of the treatment centre, procurement invoices and the Covid-19 standard treatment guidelines. The Student's t-test, Mann-Whitney U test or Kruskal-Wallis test was employed to test the difference between sociodemographic and clinical factors when appropriate.To identify the determinants of cost drivers in the study population, a generalised linear model with gamma distribution and log link with a stepwise algorithm were used.
A total of 692 Covid-19 patients were included in the costing analysis. In this study, the mean cost of Covid-19-infected patients with no symptoms was US$1,073.86, with mild symptoms US$1,100.74, with moderate symptoms US$1,394.74 and in severe-critically ill condition US$1,708.05.The overall mean cost was US$1,382.50(95% CI: 1,360.60-1,404.40) per treated episode.The highest mean cost was observed for personnel, accounting for 64.0% of the overall cost. Older age, pre-existing diseases, advanced disease severity at admission, admission to the intensive care unit, prolonged stay on treatment and intranasal oxygen support were strongly associated with higher costs.
This study found that the clinical management of Covid-19 patients incurred significant expenses to the health system. Factors such as older age, disease severity, presence of comorbidities, use of inhalation oxygen therapy and prolonged hospital stay were associated with higher hospitalisation costs.Therefore, the government should give priority to the elderly and those with comorbidities in the provision of vaccination to reduce the financial burden on health facilities and health systems in terms of resource utilisation.
2019 年冠状病毒病（Covid-19）大流行是一个全球性的公共卫生问题。Covid-19 大流行对包括埃塞俄比亚在内的发展中国家的经济产生了重大影响。本研究旨在确定 Covid-19 的住院费用以及与埃塞俄比亚中南部住院费用高相关的因素。
采用微观成本法和自上而下的方法，从卫生系统角度对 2020 年 7 月至 2021 年 7 月在 Bokoji 医院 Covid-19 治疗中心住院的 Covid-19 患者进行回顾性成本分析。该分析使用从行政报告、治疗中心财务报告、采购发票和 Covid-19 标准治疗指南中获得的成本数据。采用学生 t 检验、Mann-Whitney U 检验或 Kruskal-Wallis 检验，在适当情况下测试社会人口学和临床因素之间的差异。为了确定研究人群中成本驱动因素的决定因素，使用具有伽马分布和对数链接的广义线性模型，采用逐步算法。
共有 692 名 Covid-19 患者纳入成本分析。在这项研究中，无症状感染患者的平均住院费用为 1073.86 美元，轻度症状患者为 1100.74 美元，中度症状患者为 1394.74 美元，重症危重症患者为 1708.05 美元。每个治疗病例的总平均费用为 1382.50 美元（95%CI：1360.60-1404.40）。人员的平均费用最高，占总费用的 64.0%。年龄较大、合并症、入院时疾病严重程度较高、入住重症监护病房、治疗时间延长和鼻内吸氧支持与较高的费用密切相关。
本研究发现，对卫生系统而言，临床管理 Covid-19 患者的费用高昂。年龄较大、疾病严重程度、合并症存在、使用吸入氧气治疗和住院时间延长等因素与住院费用较高相关。因此，政府应优先为老年人和合并症患者提供疫苗接种，以减少对医疗机构和卫生系统资源利用方面的财务负担。
