The costs of HIV/AIDS care and treatment in Adigrat General Hospital, eastern zone of Tigray National Regional State, North Ethiopia

Abstract

Background: As the number of HIV /AIDS cases increases relentlessly throughout the country, hospitals are making a major commitment of resources to the treatment of HIV/AIDS and related diseases. The hospitals were significantly affected by the highest HIVAIDS prevalence in the urban secondary and tertiary hospitals and increase the demand for care and resources; therefore, this study aims to assess the hospital HIV AIDS expenditure. Objective: The objective of this study is to assess the costs of HIV/AIDS care and treatment in Adigrat General Hospital, eastern zone of Tigray, North Ethiopia. Methodology: A cross-sectional survey with retrospective data collection approach was conducted on patients utilizing HIV/AIDS care at outpatient level and admissions to inpatient wards in Adigrat general hospital from January 2009 to December 2010 G.C. A sample of 373 patient charts and registers was reviewed using a systematic random sampling method. The data were collected using a pretested checklist that contains information about HIV/AIDS stage, frequency of visit and admission, pattern of disease, investigations, drugs, and length of stay. The bottom up and step down costing method was used for direct and indirect costs respectively. The data was collected by trained diploma and above level health professionals from review of medical records and registers of patients. Moreover, two year financial record review in the hospital was conducted by the financial expert data collectors to strengthen the information. The data were entered, edited; cleaned and analyzed using IT spreadsheet (Excel) and the statistical package SPSS version 16.0 for further analysis. Percentages, averages, and regression model were used and data were presented using tables, graphs and figures. Results: Of the total 373 reviewed patient charts, The majority 59.2% , 81% and 69.2%, were females, 15-44 age group, and urban respectively. The finding revealed that Average Length of stay was 11.04 days; and the bed occupancy rate was 6.7% (17.3% of hospital admission days). The estimated hospital HIV/ AIDS cost per year was found that $5,778,972.80 Eth birr, from this the highest 80.3 % and 72.4% hospital HIV AIDS expenditure found in outpatient department and direct cost respectively. Conclusion: The study shows that Health care for HIV AIDS patients utilized large hospital resource that was provided free and financed by the hospital increased the burden and pressure on hospitals. Tigray Regional health bureau design programs to expand and cascade the outpatient HIV AIDS care and treatment to other alternative care facilities, and allow hospitals to receive supplemental reimbursement for a comprehensive HIV/ AIDS care and treatment.