Malaria in the Republic of Guinea 2022-2023: costs associated with the care pathway from the patient's perspective.

Autor: Diallo EM; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Guinea. elhadjmaroufd@yahoo.fr.; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France. elhadjmaroufd@yahoo.fr., Traore FB; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Guinea., Langlet A; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France., Onyango LA; Department of Preventive Medicine, Institute for Global Health, Northwestern University, Chicago, USA., Blanquet M; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France., Camara BS; Centre National de Recherche et de Formation en Santé Rurale (CNRFSR), Maferenyah, Forecariah, Guinea., Sidibe S; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Guinea., Camara A; African Centre of Excellence for the Prevention and Control of Communicable Diseases, Faculty of Health Sciences and Techniques, University of Conakry, Conakry, Guinea.; National Malaria Control Program (NMCP), Conakry, Guinea., Gerbaud L; CHU Clermont-Ferrand, UFR Medicine & Paramedical Professions, University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute, Aubière, France.
Jazyk: angličtina
Zdroj: Health economics review [Health Econ Rev] 2024 Nov 14; Vol. 14 (1), pp. 91. Date of Electronic Publication: 2024 Nov 14.
DOI: 10.1186/s13561-024-00570-y
Abstrakt: Background: Access to safe, financial affordable health care is a key factor in reducing health disparities. The malaria is a major public health issue, with significant economic implications in Guinea where the free malaria care services were introduced in 2010. This paper analyzes the costs associated with the care pathway for malaria patients in the Republic of Guinea.
Methods: An analysis of the costs associated with malaria disease was conducted using data from a cross-sectional survey on the determinants of malaria care pathway between December 2022 and March 2023. The data were collected in health facilities and at community health workers. According to the patient's perspective, Time-Driven Activity-Based Costing (TDABC) and micro-costing approaches were used to assess the costs associated with care-seeking, cases management, and income loss.
Results: A total of 3300 patients were recruited in 60 health facilities. The majority were in urban areas (64.8%). One third of the patients were children under five years old. Over half of the patients or caregivers were without formal education, and most households were headed by husbands (78.5%). The median monthly income of the head of households was $116.0. Furthermore, after diagnosis, 25.5% of cases were uncomplicated malaria, 19.2% were complicated, and 52.2% were malaria associated with other diseases. Globally 41% of cases were on their first care pathway. The costs of care-seeking varied according to type of malaria, from $3.5 and $13.5 respectively for uncomplicated and complicated cases. The median direct costs of case management at health facilities were $7.3 (IQR: $4.1,13.3) for uncomplicated and $30.5 (IQR: 15.7, 51.4) for complicated cases. The total costs associated with the global care pathway differed across types of malaria and age groups, with median costs estimated at $17.4 (IQR: 6.7, 34.8) for uncomplicated cases and $43.5 (IQR: $ 19.7, 74.0) for complicated malaria. A delay in appropriate care-seeking accounted for 19% of the costs incurred by malaria patients in Guinea (p < 0.001).
Conclusion: Despite the introduction of free malaria prevention services, malaria patients or their caregivers continue to incur costs and loss of income. An approach to selective, free and affordable flat-rate costs could ensure the financial viability of health facilities and reduce out-of-pocket expenses. The next research will focus on the impact of free selective and flat-rate pricing on out-of-pocket expenses, and the analysis of the perception of the malaria care services by care providers and users.
Competing Interests: Declarations Ethics approval and consent to participate The study was approved by the National Ethics Committee for Health Research of Guinea (reference number #151/CNERS, 2022). This study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent is obtained from each patient or caregiver prior to data collection. Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: