Costs of Treating Uncomplicated Sickle Cell Complications in a Day Hospital Setting in Equatorial Africa

Area of Science:

• Public Health
• Health Economics
• Hematology

Background:

• Sickle cell disease (SCD) poses a significant public health challenge in Africa.
• In the Congo, individuals with SCD bear healthcare costs personally due to a lack of universal health insurance.
• Outpatient management is one strategy explored to mitigate the economic burden of SCD.

Purpose of the Study:

• To evaluate the economic costs associated with the outpatient management of uncomplicated sickle cell crises.
• To assess the consistency of outpatient SCD treatment with established standards of care.

Main Methods:

• A study was conducted at the National Sickle Cell Center's emergency room from December 2023 to February 2024.
• Data collected included chief complaint, diagnosis, treatment, insurance coverage, and cost of care for 114 patients with uncomplicated SCD crises.
• Patient demographics, employment status, and income were also recorded and compared to a control group.

Main Results:

• The average cost for outpatient management of uncomplicated SCD crises was $99.86, with medications accounting for 55.7% of the total expense.
• Over half of the patients (57%) received unnecessary investigations and medications, increasing costs by $15.96 per person.
• Individuals with SCD had lower average monthly incomes ($310.32) compared to those without SCD ($386.92).

Conclusions:

• The current outpatient management strategy for uncomplicated sickle cell crises in the Congo did not demonstrate significant financial benefits.
• Unnecessary medical interventions contribute to inflated costs for SCD patients.
• Further research is needed to develop cost-effective strategies for SCD management in resource-limited settings.