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Routine paediatric sickle cell disease (SCD) outpatient care in a rural Kenyan hospital: utilization and costs
Djesika D Amendah1, George Mukamah, Albert Komba
1African Population Health Research Center, Nairobi, Kenya. damendah@aphrc.org
Insights
The annual cost for routine sickle cell disease (SCD) outpatient care in rural Kenya is estimated at USD 138 per child. This study provides crucial data for healthcare policy in sub-Saharan Africa.
Area of Science:
- Global Health
- Pediatric Hematology
- Health Economics
Background:
- Sickle Cell Disease (SCD) disproportionately affects over 70% of children in sub-Saharan Africa, with prevalence rates up to 2% in some regions.
- There is limited data on the comprehensive care and associated costs for children with SCD in sub-Saharan Africa.
- Understanding these costs is vital for establishing effective prevention and treatment strategies at national and international levels.
Purpose of the Study:
- To determine the per-patient costs associated with routine outpatient care for Sickle Cell Disease (SCD) at a rural hospital in Kenya.
- To provide essential economic data for healthcare planning and resource allocation for SCD management in similar settings.
Main Methods:
- Cost data was gathered from administrative records and primary sources within the SCD outpatient clinic and supporting departments at Kilifi District Hospital, Kenya.
- Economic costs were calculated by assessing inputs such as equipment, medications, supplies, facility usage, utilities, and personnel.
- Annual economic costs were determined using input costs, prorated equipment lifespan, and an appropriate discount rate, with sensitivity analyses conducted for varying pay scales and discount rates.
Main Results:
- The estimated annual economic cost per patient for SCD outpatient care was USD 138 in 2010.
- The cost per patient ranged from USD 94 to USD 229, indicating variability in resource utilization or cost factors.
Conclusions:
- This research presents the first published cost estimate for routine outpatient care of children with SCD in sub-Saharan Africa.
- The findings offer policymakers valuable insights into the potential future expenses of maintaining specialized outpatient clinics for children with SCD in comparable regions.
- This study underscores the need for continued economic evaluation to support sustainable SCD care models in resource-limited settings.
Background:
More than 70% of children with sickle cell disease (SCD) are born in sub-Saharan Africa where the prevalence at birth of this disease reaches 2% or higher in some selected areas. There is a dearth of knowledge on comprehensive care received by children with SCD in sub-Saharan Africa and its associated cost. Such knowledge is important for setting prevention and treatment priorities at national and international levels. This study focuses on routine care for children with SCD in an outpatient clinic of the Kilifi District Hospital, located in a rural area on the coast of Kenya.
Objective:
To estimate the per-patient costs for routine SCD outpatient care at a rural Kenyan hospital.
Methods:
We collected routine administrative and primary cost data from the SCD outpatient clinic and supporting departments at Kilifi District Hospital, Kenya. Costs were estimated by evaluating inputs - equipment, medication, supplies, building use, utility, and personnel - to reflect the cost of offering this service within an existing healthcare facility. Annual economic costs were similarly calculated based on input costs, prorated lifetime of equipment and appropriate discount rate. Sensitivity analyses evaluated these costs under different pay scales and different discount rate.
Results:
We estimated that the annual economic cost per patient attending the SCD clinic was USD 138 in 2010 with a range of USD 94 to USD 229.
Conclusion:
This study supplies the first published estimate of the cost of routine outpatient care for children born with SCD in sub-Saharan Africa. Our study provides policy makers with an indication of the potential future costs of maintaining specialist outpatient clinics for children living with SCD in similar contexts.
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