Cost of Initial Care for Preterm Infants at Bolgatanga Regional Hospital, Ghana

W. Ofosu
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Abstract

Preterm birth is an important public health problem due to its medical, economic, and social impact and constitutes about 10% of annual global births. To improve access and equity to health care delivery of preterm infants, identification of major cost areas and strategies to improve efficiency in those areas must be prioritized. This study estimated the health system cost of neonatal intensive care unit (NICU) services for preterm babies in the Regional Hospital, Bolgatanga (RHB). A costing study based on health system perspective designed to estimate cost of initial hospital care for preterm babies was carried out in RHB. Participants were selected based on systematic sampling procedure of preterm babies admitted at the facility from January 2019 to December 2019. The health system and cost estimates of NICU services were done using both top-to-bottom and micro-costing approaches. Preterm births constituted 30% of NICU admissions in 2019. Most preterm infants were of low birth weight (LBW). The total cost for providing initial hospital care for preterm infants in 2019 was GH₵212,776.96 ($35,462.83). The major cost component was shared cost making up 59.20%, especially staff salaries. Direct medical cost constituted 40.80% of the total cost. The RHB would have saved GH₵212,776.96 ($35,462.83) in 2019 if preterm births were eliminated. Prioritizing efficient use of shared resources would save cost for increase access to preterm care. Keywords: Cost of initial hospital care, LBW, NICU, Preterm birth, Prevalence, Direct medical cost, shared cost, RHB.
加纳博尔加坦加地区医院早产儿初始护理费用
由于其医疗、经济和社会影响,早产是一个重要的公共卫生问题,约占全球每年出生人数的10%。为了改善早产儿获得保健服务的机会和公平,必须优先确定主要成本领域和提高这些领域效率的战略。本研究估计了Bolgatanga (RHB)地区医院早产儿新生儿重症监护病房(NICU)服务的卫生系统成本。在RHB进行了一项基于卫生系统视角的成本计算研究,旨在估计早产儿最初住院治疗的成本。参与者是根据2019年1月至2019年12月在该机构入院的早产儿的系统抽样程序选择的。NICU服务的卫生系统和成本估算采用自上而下和微观成本计算方法。2019年,早产占新生儿重症监护病房入院人数的30%。早产儿多为低出生体重儿(LBW)。2019年为早产儿提供初步住院治疗的总费用为GH美分212,776.96(35,462.83美元)。主要的费用组成部分是分担费用,占59.20%,特别是工作人员薪金。直接医疗费用占总费用的40.80%。如果消除早产,RHB将在2019年节省GH美分212,776.96(35,462.83美元)。优先考虑有效利用共享资源将节省成本,增加获得早产儿护理的机会。关键词:初次住院治疗费用,新生儿体重,新生儿重症监护室,早产,患病率,直接医疗费用,分担费用,RHB。
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