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Burden and cost of inpatient care for HIV-positive paediatric patients – status in the Cape Town metropole during the second week of March 1999
Abstract
Objective. To determine the burden of the HlV epidemic on paediatric inpatient facilities in the teaching hospitals of the Cape metropole and tributaries to these hospitals.
Setting. Second- and third-level hospitals.
Method. During the second week of March 1999 a multicentre collaborative census was performed of all paediatric beds in the teaching hospitals of Cape Town and all facilities draining to and from them.
Results. One hundred and six HlV-infected patients were identified from a total of 1 264 beds. Thirty-nine children were in second-level beds or in a long-term residential facility. Fifty-six children were in second-level beds designated for acute care, and occupied 12% of all such beds. Ten children were in beds designated for the care of tuberculosis. Thirty-two (56%) of the acute admissions were for gastro-enteritis, and 13 (23%) were for pneumonia. In 10 children (18% of all admissions) recognised complications of HN infection were direct causes of admission. For 29 children (35% of all admissions) the current admission was the first; the remainder had had a mean of 2.4 previous admissions. Fourteen children (25%) had received oxygen, and 26 (46%) had received intravenous therapy. Mean lifetime hospitalisation cost per infected child was calculated to be R19 712. The projected cost of a local initiative to reduce mother-to-child transmission is between R8 326 and R10 806 per vertical infection prevented.
Conclusion. The inpatient burden of HN-infected children in Cape Town reflects an early stage of the epidemic. Compared with projected lifetime hospitaliSation cost for infected children, an intervention to reduce vertical transmission cost would be cost effective.
