Economic Costs of Providing District- and Regional-Level Surgeries in Tanzania

• DOI: 10.34172/ijhpm.2021.09
• Publication Date: 2021-03-06T05:59:16Z
• Authors: Martilord Ifeanyichi; Henk Broekhuizen; Adinan Juma; Kondo Chilonga; Edward Kataika; Jakub Gajewski; Ruairi Brugha; Leon Bijlmakers
• Keywords: District hospital; Health Economics

Access to surgical care is poor in Tanzania. The country at the implementation stage of its first National Surgical, Obstetric, and Anesthesia Plan (NSOAP; 2018-2025) aiming scale up surgery. This study aimed calculate costs providing district regional hospitals. Two hospitals (DHs) referral hospital (RH) Arusha region were selected. All staff, buildings, equipment, medical non-medical supplies deployed running over a 12 month period identified quantified from interviews records. Using combination step-down costing (SDC) activity-based (ABC), all attributed surgeries established then distributed individual types surgeries. These delineated into pre-operative, intra-operative, post-operative components. total annual clinical cost centres ranged $567k Oltrumet DH $3453k Mt Meru RH. $79k $813k; amounting 12%-22% At least 70% salaries. Unit relative shares capital generally higher DHs. Two-thirds procedures incurred 60% their theatre. Open reduction internal fixation (ORIF) performed was cheaper ($618) than debridement (plus conservative treatment) due prolonged inpatient associated with latter ($1177), but infrequently mostly unavailability implants. Lower unit RH reflect an advantage economies scope RH, possible underutilization capacity Greater efficiencies make case for concentration scale-up services RHs, there stronger scaling district-level surgeries, not only equitable access services, also drive down there, free resources more complex cases such as ORIF.