The direct cost of care among surgical inpatients at a tertiary hospital in south west Nigeria

Abstract

Introduction: This study was conducted to assess the direct cost of care and its determinants among surgical inpatients at university College Hospital, Ibadan. Methods: A retrospective review of records of 404 inpatients that had surgery from January to December, 2010 was conducted. Information was  extracted on socio-demographic variables, investigations, drugs, length of stay (LOS)and cost of  carewith a semi-structured proforma. Mean cost of care were compared using t-test and Analysis of  variance (ANOVA). Linear regression analysis was used to identify determinants of cost of care. Level of significance of 5% was used. In year 2010 $1 was equivalent to 150 naira ($1=₦ 150).

Results: The median age of patients was 30 years with inter-quartile range of 13-42 years. Males were  257(63. 6%). The mean overall cost of care was ₦66,983 ± ₦31,985. Cost of surgery is about 50% of total cost of care. Patient first seen at the Accident and Emergency had a significantly higher mean cost of care of ß = ₦17,207(95% CI: ₦4,003 to ₦30,410). Neuro Surgery (ß=₦36,210), and Orthopaedic Surgery versus General Surgery(ß=₦10,258),and Blood transfusion (ß=₦18,493) all contributed to cost of care significantly. Increase of one day in LOS significantly increased cost of care by ₦2,372. 57.

Conclusion: The evidence evaluated here shows that costs and LOS are interrelated. Attempt at reducing LOS will reduce the costs of care of surgical inpatient.