An Analysis of patient care cost for selected preventable diseases in intensive care unit at Lady Ridgeway Hospital in 1992
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Date
1994
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Post Graduate Institute of Medicine, Colombo: PGIM .
Abstract
A retrospective study was performed to calculate the cost of intensive therapy of the patients with preventable conditions, admitted to LRH, ICU in 1992, on an individual basis. The study revealed that the Ministry of Health has achieved a certain level of success in controlling the preventable diseases. Intensive care utilization for this categories was only 23 percent as compared to 77 percent for non preventable diseases. Per patient day cost at the ICU was Rs.3,306.00. Which is almost ten times greater than that for general ward treatment at LRH. The cost was studied in terms of the ficed (equipment, building) 12 percent, semi ficed (staff emoluments and administration) 31 percent and variable (treatment) costs 57 percent. Emoluments of staff was 30 percent of the total cost. The mortality rate for patients with preventable diseases had remained at a high level (60 percent). 70 percent of the preventable conditions were due to birth asphyxia and complications of LBW. These two conditions produce high incidence of admissions under one month (97 percent out of all neonates). The money spent on treatment of birth asphyxia and LBW at LRH ICU would be sufficient to provide 175 ambu bags and 85,000 hand mucus extractors to reach an island wide coverage. Control programmes specific for these two problems with wide coverage is a need of the day. Among the nin preventable diseases, there were patients with long standing public health problems such as complications of worm infestation (0.7 percent), gastroenteritis (4.1 percent), malaria (0.7 percent), neonatal tetanus (1.4 percent), tetanus (1.4 percent),Tuberculosis (1.4 percent) and typhoid (0.7 percent). There were also patients appearing with newly highlighted public health problems such as dengue haemorragic fever (2.1 percent) and encephalitis (7.5 percent) which could be a major public health problems in the future. 8.9 percent of patients presented as poisoning which is easily preventable. 55 percent of the total ICU cost for preventable diseases has consumed by non survivors as compared to the cost consumed by survivors. This highlights well known important concept of prevention is better than cure. There is a growing demand for intensive care by the health professionals and other pressure groups, this may not be a right investment considering the loss of opportunity of primary and secondary care for large numbers due to lack of resources. While accepting the fact, that intensive care are integral part of tertiary care these should not be established at the expense of basic primary care.
Description
Dissertation: M.Sc.(Community Medicine), Post Graduate Institute of Medicine, Colombo: PGIM , 1994.
Keywords
Child health services
Citation
JAYATISSA, KLR, An Analysis of patient care cost for selected preventable diseases in intensive care unit at Lady Ridgeway Hospital in 1992, Post Graduate Institute of Medicine, Colombo PGIM , 1994: p.