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The cost of providing hypertension health care in public health facilities case study of the NCD clinic at Rwinkwavu district hospital


MOJ Public Health
Deogratias Ndagijimana,1 Bethany Hedt Gauthier,2 Connie Mureithi,3 Alyse Kennedy,1

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Abstract

Background: The cost of hypertension healthcare services is increasing worldwide due to increase of its prevalence estimated to 40% in adults globally and high prevalence 46% is in Sub-Saharan African. The purpose of this study is to provide information of the cost of hypertension health care services in monetary values on one hand and to determine the cost of health care services of each stage of hypertension at district hospital in rural Rwanda. The study benefits the care givers of hypertension care to understand the socio-economic status of the patients and plan their management.
Methods: Retrospective study of 68 patients followed-up in the NCD clinic from January to December, 2013. The data have been collected using patients’ files included demographic information, numbers of visits, diagnostic tests and medications. The Ministry of Health tariff, the information from the charts and Excel cost analysis was done to discover the average cost per patient and requirement of good care at each stage of hypertension.
Results: Of the 68 patients analyzed, 74% were female and 26% were male. Their socio-economic status was generally very low; most of the patients had zero formal education 37% and 34% patients had only a primary education level; 53% patients were famers owned small pieces of lands which are not considerably productive and 18% patients were unemployed. The cost of providing hypertension healthcare services estimated in monetary values was 53,656,736 Rwf excluding the maintenance cost in financial year 2013. The driving cost of hypertension care delivery was the expenditure on medicines, which were estimated at 9,343,956 Rwf per year. The capital cost was 52% and the recurrent cost was 65% of the total cost of hypertension care. The average costs of hypertension care per patient for each stage per year were 25,431 Rwf for stage one, 45,812 Rwf for stage two and 82,778 Rwf for stage three.
Conclusion and implications for translation: The overall control of hypertension with insurance coverage is good at Rwinkwavu District Hospital. Hypertension health care services can be effectively implemented in every district hospital in Rwanda through the NCD program. The cost of providing hypertension health care services information are critically missing in the region, more studies are needed on cost of NCDs health care services and their countries’ economy impact as the prevalence increasing rapidly.

Keywords

hypertension, out-of-pocket payments, health insurance, ncd, health care services, healthcare access, program, insurance, coverage, rapidly, increasing, seasonal, temporary, partial, exclusion

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