Costing of Antiretroviral Treatment in Mbagathi District Hospital, Kenya

Abstract

Kenya has made positive progress towards achieving Millennium Development Goals and Vision 2030; however, HIV and AIDS remains a major challenge, causing premature mortality and morbidity and unless its impacts are controlled the country may not achieve its development goals. Antiretroviral therapy is one of the response mechanisms that are being implemented globally to mitigate the impact of HIV. The objectives of this study was to estimate the unit costs of labour, laboratory and imaging services, average cost per inpatient day and the average cost of outpatient visit per quarter in Mbagathi District Hospital. The cost and health service utilization data was collected retrospectively for a period of 24 months from the electronic medical records and patient charts of 351 HIV-positive adults who were enrolled on ART treatment in Mbagathi. Using micro-costing and gross-costing methods, we estimated the economic cost of the comprehensive HIV treatment. The average cost of outpatient visit per quarter was estimated to be Ksh9,044 (USD120.83)during the three months of treatment debut. This decreased over the two years of follow-up to Ksh5,818 (USD77.73) while the average cost per outpatient visit stood at Ksh2,001 (USD26.73). The average outpatient cost per annum was Ksh26,040 (USD347.90)and Ksh20,506 (USD273.96) in  the first and the second year of treatment, respectively. The average cost of treatment per inpatient day was Ksh1,691 (USD22.59). The average labour cost per outpatient visit was Ksh465 (USD6.21) while that of inpatient per day was Ksh575 (USD7.68). Generally, ART accounted for the highest proportion of costs followed by the labour and laboratory test. The study provides new and relevant information in terms of the unit costs of inpatient and outpatient care, labour, laboratory and imaging.