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The cost of home-based terminal care for people with AIDS in South Africa

journal contribution
posted on 2002-08-01, 00:00 authored by Leana Uys, Martin Hensher
OBJECTIVES: To describe the costs of establishing and operating a home-based care (HBC) project providing palliative care for people with AIDS (PWA), and to project the full costs to the health care system of extending this care model. DESIGN: Data were collected from seven sites participating in the Hospice Association of South Africa integrated community home-based care (ICHC) model, using site records, interviews with personnel, a continuity of care survey of nursing staff supervising the sites, and time logs kept by community caregivers (CCGs). The seven sites were spread across five provinces, with a mix of rural, peri-urban and urban settings. OUTCOME MEASURES: Set-up (training, equipping and planning) costs per HBC site, HBC operating costs (total and average cost per patient), and average hospital inpatient, hospital outpatient and primary care clinic cost per participating patient. Estimates of scaling up this model of HBC to national roll-out are also provided. RESULTS AND CONCLUSIONS: Providing palliative HBC to PWAs in their last year of life using the ICHC model costs R2 840 per patient per year. Even with this level of HBC input, patients still incurred hospital costs of R2 522 and primary care clinic costs of R1 154 per patient per year. HBC costs are increased in rural areas where a vehicle is required for staff transport. HBC shows considerable potential to deal cost-effectively with growing palliative care needs in the face of the AIDS epidemic, but we need to understand better the true extent to which HBC can substitute for hospitalisation.

History

Journal

South African medical journal

Volume

92

Pagination

624-628

Location

Cape Town, South Africa

ISSN

0256-9574

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2002, Medical Association of South Africa

Issue

8

Publisher

Medical Association of South Africa

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