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  • Title: Resource utilization patterns in patients with acquired immunodeficiency syndrome (AIDS).
    Author: Okello DO.
    Journal: East Afr Med J; 1994 Dec; 71(12):816-7. PubMed ID: 7705257.
    Abstract:
    A survey in 1991 of resource use patterns and factors affecting the cost of care for the acquired immunodeficiency syndrome (AIDS) in Mulago Hospital, Kampala, Uganda, revealed that drugs constitute 97% of the mean cost of care of affected individuals in the outpatient and 37% in hospitalized patients. The cost of drugs per treatment episode was Ug.Sh.5785.00 in the outpatient and Ug.Sh.8309.00 for inpatients. (The exchange rate for 1991 was US$ = Ug.Sh.910.00). Analysis of an attempt to provide essential drugs for the growing number of AIDS subjects shows that drugs alone could consume the entire health budget of the Ministry of Health in Uganda. There is therefore need to critically consider options to control the high cost for drugs in AIDS care. A study was conducted in Kampala, Uganda, to assess drug utilization by AIDS patients. The study on AIDS resource use patterns was carried out in the general wards and outpatient clinic for AIDS patients at Mulago Hospital, a tertiary care university teaching hospital. 740 admissions for AIDS and 1074 AIDS outpatient clinic visits were included during March-October 1991. Hospital resource utilization including the use of drugs by AIDS patients was assessed and the cost of various service categories estimated using a standard resource cost list. The mean cost of care per episode of AIDS admission was Ugandan Shilling 22,580.00. In the outpatient the mean cost of care per episode of clinic visit was Ug.Sh. 5952.00. The top drugs used in the hospital were: cotrimoxazole, metronidazole (Flagyl), ketoconazole, chlorpromazine, chloroquine, aspirin or paracetamol, codeine, calamine lotion, and petroleum jelly. Drugs constituted the single most important service category of care in the outpatient clinic, accounting for 97% of outpatient service costs. The mean cost of drugs per outpatient visit was Ug.Sh. 5785.00, while the remainder of the other service categories in the outpatient had a combined mean cost of Ug.Sh. 167.00 (3% of the total). Similarly, for inpatients drugs also constituted the most expensive category of care, accounting for 37% of the mean cost of care compared to 19% for laboratory services and 15% for hotel costs. The mean cost of drugs per treatment episode for inpatients was Ug.Sh. 8309.00. The mean cost of the commonly used drugs per treatment episodes ranged from Ug.Sh. 240.00 to 8000.00 in the outpatient, and 240.00 to 9600.00 in hospitalized patients. The top drugs associated with the highest mean cost per treatment episode were: ketoconazole, cotrimoxazole and metronidazole used for the treatment of oral candida and gastrointestinal symptoms.
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