Kirigia J M, Snow R W, Fox-Rushby J, Mills A
Department of Community Health, University of Cape Town, South Africa.
Trop Med Int Health. 1998 Feb;3(2):145-50. doi: 10.1046/j.1365-3156.1998.00204.x.
To calculate the costs at Kilifi District Hospital (KDH) and Malindi Sub-district Hospital (MSH) of treating paediatric malaria admissions including three common presentations of severe paediatric malaria, i.e. cerebral malaria, severe malaria anaemia and malaria-associated seizures; and to estimate the implications for hospital expenditure of a reduction in paediatric malaria admissions.
Patient data were obtained from hospital records. All costs were allocated to departments that provided direct patient care by a four-stage step-down procedure. Laboratory and drug costs of treating paediatric malaria admissions were separately identified.
Unit recurrent costs per admission in KDH ranged from US $57 for 'other' paediatric malaria to US $105 for cerebral malaria, and in MSH from US $33 to US $44 for the same categories. The annual recurrent cost of treating all paediatric malaria admissions to KDH prior to the trial was estimated at US $78 900. Adjusting for preintervention differences in malaria admission rates and age between intervention and control areas, the ITBN trial found a 41% reduction in paediatric malaria admissions. The reduction in admissions resulted in an estimated saving of US $6240 in the cost of treating paediatric malaria admissions from the intervention area.
There would be a substantial reduction in costs of treating paediatric malaria admissions if the intervention were introduced in the whole catchment area of the hospital. Actual savings would depend on the proportion of potential savings that can in practice be realised, and on the effectiveness of the intervention when routinely implemented.
计算基利菲区医院（KDH）和马林迪分区医院（MSH）治疗小儿疟疾住院病例的费用，包括小儿重症疟疾的三种常见表现形式，即脑型疟疾、重症疟疾贫血和疟疾相关性惊厥；并估计小儿疟疾住院病例减少对医院支出的影响。
从医院记录中获取患者数据。所有费用通过四阶段逐步递减程序分配到提供直接患者护理的科室。分别确定治疗小儿疟疾住院病例的实验室和药物费用。
KDH每例住院病例的单位经常性费用从“其他”小儿疟疾的57美元到脑型疟疾的105美元不等，MSH相同类别费用从33美元到44美元不等。试验前KDH治疗所有小儿疟疾住院病例的年度经常性费用估计为78900美元。根据干预区和对照区疟疾住院率和年龄的干预前差异进行调整后，ITBN试验发现小儿疟疾住院病例减少了41%。住院病例的减少估计使干预区治疗小儿疟疾住院病例的费用节省了6240美元。
如果在医院的整个集水区引入该干预措施，治疗小儿疟疾住院病例的费用将大幅降低。实际节省的费用将取决于实际可实现的潜在节省比例，以及常规实施该干预措施时的有效性。
