The Hospital Costs Associated with Acute Paediatric Burn Injuries

Background. Ongoing rationing of healthcare threatens services that are well established; and cripples others that desperately require investment. Burn; for one; remains a neglected epidemic in South Africa (SA); despite the magnitude of the problem.Objective. To identify the prominent components contributing to the cost of hospital admission with paediatric burn injury. Determining the true costs of specialist services is important; so that resources can be allocated appropriately to achieve the greatest possible impact.Methods. A retrospective study was undertaken over 1 year to determine patient demographics and injury details of 987 patients admitted with burn injuries to Red Cross War Memorial Children's Hospital; Cape Town; SA. The in-hospital financial records of 80 randomly selected patients were examined. This was followed by a prospective study to determine the financial implications of four cost drivers; i.e. bed cost per day; costs of medications received; costs of dressings for wound care; and costs of surgical intervention. A random selection of 37 dressing changes (in 31 paediatric patients) and 19 surgical interventions was observed; during which all costs were recorded.Results. As expected; severe flame burns are responsible for more prolonged hospital stays and usually require surgical intervention. Scald burns comprise the greatest proportion of burn injuries; and therefore account for a considerable part of the hospital's expenditure towards burn care.Conclusion. While community programmes aiming to prevent burn injuries are important; this study motivates for the implementation of accessible ambulatory services in low-income areas. This strategy would enable the burn unit to reduce its costs by limiting unnecessary admissions; and prioritising its resources for those with more severe burn injuries

A Profile on and Medical Conditions of Patients Staying Longer Than the Set Norm at a District Hospital in South Africa

The average length of hospital stay is regarded as a key determinant of greater hospital costs. The objectives of this quantitative; retrospective; descriptive study were to determine the health status and medical conditions of patients with increased length of stay at a district hospital in Limpopo Province. A total of 609 patients' records with longer than average length of stay; from January to December 2007; were selected by stratified random sampling. The most prevalent diseases for staying longer were infectious and parasitic diseases; symptoms; signs etc; and injury; poisoning and consequences of causes yielding more than a third (36 and 12; respectively; for each classification). Neoplasm-related admissions; in which cancer was identified as the most prevalent; stayed in hospital for an average of 14.6 days. The average length of stay for all disease classifications ranged from 7.1 days to 14.6 days. The length of stay at Elim Hospital is mostly influenced by the type of health conditions which are diagnosed. Further research is needed to find influential factors that might contribute to patients staying longer than normal