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Syndromic management of common illnesses in hospitalized children and neonates: a cost identification study
Subhashchandra Daga1, Bela Verma, Satish Shahane
1Cama and Albless Hospital, Mumbai, India. subhashdaga@yahoo.com
Insights
This study analyzed pediatric drug treatment costs for common illnesses. Average medicine costs were $4.20 per child and $20 for newborns, informing cost-effective treatment strategies.
Area of Science:
- Pediatric Medicine
- Health Economics
- Pharmacoeconomics
Background:
- Understanding drug treatment costs is crucial for healthcare resource allocation in pediatric wards.
- Common childhood illnesses present significant treatment expenditure challenges in developing countries.
Purpose of the Study:
- To determine the drug treatment cost per illness per patient admitted to a pediatric ward.
- To analyze medication expenses for common pediatric conditions and newborns.
Main Methods:
- A prospective observational study included 774 children and 141 newborns admitted over one year.
- Drug expenditures were individually calculated for patients presenting with fever, respiratory distress, diarrhea, malnutrition, or neurological issues.
- Patients were categorized by illness severity (critically ill, sick, stable), and costs for oxygen and inotropes were recorded.
Main Results:
- The average drug treatment cost was INR-167.8 ($4.2) per child and INR-790 ($20) per newborn.
- Fever was the most common presentation (73.4%), followed by malnutrition (35.8%).
- Average hospital stay was 7.1 days for children and 9.8 days for newborns.
Conclusions:
- This cost analysis provides essential data on drug treatment expenses for prevalent pediatric illnesses in a developing country's referral center.
- Findings can guide the selection of cost-effective medications for optimal patient outcomes.
Objective:
To find out drug treatment cost per illness per patient admitted to pediatric ward.
Methods:
Patients admitted to pediatric ward over a period of 1 year were studied without exclusions. Following presentations were studied: fever, rapid breathing, diarrhea, severe malnutrition and neurological problems such as altered conscious level or convulsion. In this prospective observational study, patients with other problems were excluded. The subjects were also categorized as critically sick, sick and stable. Expenditure on medicines was calculated individually for each patient. Total expenditure, average cost and illness-wise cost were subsequently derived. Management of illnesses was on the lines of existing guidelines of our center. Sick newborns or newborns referred for special care were separately studied. Following outcome variables were studied: death or discharge, length of hospital stay and the day on which symptomatic relief was noted.
Results:
774 children and 141 newborns were studied. 25(3.2%) died. Presenting features were as follows: fever-568 (73.4%), rapid breathing-175 (22.6%), diarrhea-145 (18.7%), mild-moderate malnutrition-278 (35.8%), severe malnutrition-111 (14.3%) and neurological problems-41 (5.3%). Category-wise distribution was as follows: critically sick-89 (11.3%), sick-188 (24.3%) and stable-497 (46.2%). Average hospital stay was 7.1 days and symptomatic relief was experienced by day three in 77.7% cases. Average cost of medicines per patient was INR-167.8 (USD-4.2), 173 patients required oxygen and mean expenditure on oxygen was INR-310 (USD-8) and 68 patients required inotropes with a mean expenditure of INR-198 (USD-5). Of the 141 newborns admitted, 20(14.1%) died. Mean hospital stay was 9.8 days and average cost of drug treatment was INR-790 (USD-20) in newborns.
Conclusions:
This cost analysis study presents drug treatment costs for common illnesses at a referral centre in a developing country. It gives an option to choose drugs for an optimum mix of cost and effectiveness.
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