Cut Covid-19 hospital costs by 70 per cent — MoH, Kemri

 

Public hospitals should reduce the cost of Covid-19 treatment by up to 70 per cent, according to a guidance given by the Ministry of Health and Kenya Medical Research Institute.

Last year, when the disease broke out and prices of PPE shot globally, asymptomatic and patients with mild disease paid about Sh21,400 per day of admission.

The new analysis recommends they should pay only about Sh6,719 per day.

Researchers said the reduced costs are still high and may not be covered by the National Hospital Insurance Fund.

In July last year, Kemri’s policy brief recommended patients with severe Covid-19 who need oxygen therapy pay Sh24,705 per day.

The new analysis shows they should now pay Sh13,137 per day.

There is little change for patients on home-based care. Last year, they paid Sh2,442 per day for professional care at home.

The study now recommends not more than Sh2,000.

Researchers said these costs are still out of reach to most Kenyans. They are also unsustainable for NHIF.

“For instance, when compared with the average claims value (Sh40,000) reported by Kenya’s national health insurer, the NHIF, hospital management of asymptomatic and mild-to-moderate Covid-19 is two times higher while that for severe disease is four times higher,” they say.

The cost of management in ICUs has gone up.

Last year, Kemri recommended Sh51,684 for critical Covid-19 patients in ICUs. This year, they have recommended about Sh63,243 per day.

The analysis was developed by Health CAS Mercy Mwangangi, Kemri-Wellcome Trust Nairobi director Edwine Barasa, and Kemri researchers Vincent Were, Samuel Akech and Angela Kairu.

Others on the team are University of Nairobi don Marybeth Maritim and Wangari Ng'ang'a of the presidential policy and strategy unit.

The costs are not legally binding and are only meant to guide health facilities and the government’s Covid-19 response.

The researchers were funded by the International Decision Support Initiative and the Kemri-Wellcome Trust Research Programme.

Their study was published last week in the BMJ Global Health journal.

To develop the costs, the researchers said they identified all inputs required for clinical case management, their quantities and costs.

“We obtained costs for medicines, and non-pharmaceuticals from market prices reported in the 2020 Kenya drug index catalogue,” they said.

They noted hospital care is driven by PPE, accommodation and overhead (hotel) costs, and staff costs.

Estimates for accommodation and overheads were obtained from median costs reported in a cost analysis of 20 healthcare facilities in the 2018’s Value TB study.

The authors recommend Kenya should actively mobilise both domestic and donor resources to meet Covid-19 treatment costs on behalf of patients.

“If these costs are passed to patients as direct healthcare costs, they will result in substantial levels of catastrophic healthcare expenditures and impoverishment,” they said.

They noted that the costs given were for public health facilities, and therefore private hospitals might charge more, or less.

However, the guidance fails to analyse costs for the range of possible Covid-19 complications, which means some patients might still pay more.

“This is because unit costs exist for some of these, for instance for kidney replacement therapy, and costing the entire range of possible complications would require data that were not available given the fieldwork restrictions as a result of physical distancing measures,” the authors said.   BY THE STAR