Coronavirus patients in hospitals paying more for PPEs and care

Covid-19 patients are paying up to Sh234,000 for Personal Protective Equipment (PPE) alone, a new report on hospital charges says.

The report, which breaks down the cost of treating Covid-19 in the country, shows patients in home-based care are better off as they can save up to Sh69,000 by not being confined in either a hospital or an isolation centre.

The report titled Examining Unit Costs for Covid-19 Case Management in Kenya, says PPEs and staff care are the leading reasons why the cost of taking care of patients in hospitals is high.

Report author

The report compiled by Edwin Barasa from Health Research Economic Unit at Kenya Medical Research Institute/Wellcome Trust shows that PPEs increase the bills for Covid-19 hospital care by 70 per cent.

The cost of taking care of an asymptomatic patient in home-based care is Sh1,993, according to the report. However, when PPE is added – priced at Sh18,856 – the cost shoots up.

If the same patient is taken care of in a hospital, the cost of managing the disease rises to Sh88,983. This higher cost is because of the increase in staff charges to Sh14,279 from Sh2,243 when on home-based care and additional accommodation charges of Sh31,200.

If the patient is mild or moderately sick, then by being on home-based care, one can save Sh65,063. This is because while it costs Sh1,995 per day to manage a mildly or moderately symptomatic patient, adding PPE raises the cost to Sh23,942.

Cost up

If this patient is managed in a facility, then the cost goes further up to Sh89,009.

“Our findings show that unit costs for home-based care are four times lower than those for institutional care resulting in substantial costs savings,” the report reads.

It explains that not all asymptomatic and mild to moderate disease patients qualify for home-based care, and some will still need to be institutionalised because they are high risk or their home environments are unsuitable.

The findings of these charges are based on analysing 20 hospitals in the country and the market prices of the pharmaceuticals, non-pharmaceuticals and equipment.

For Covid-19 patients who are critical, apart from oxygen and ventilator charges, they incur Sh243,173 for PPEs, which is 34 per cent of the whole bill that amounts to Sh712,433.

Unit cost for oxygen therapy for these patients is Sh15,676 while equipment for intensive care unit including ventilators is Sh12,887. Cost of staff care for these patients is Sh350,512.

“Patients with critical disease incur higher intensive care related costs that include special staff (critical care physicians, anaesthetists) and more staff time per patient, pharmaceuticals (antibiotics and anaesthesia medicine) and non-pharmaceuticals (total parenteral nutrition), mechanical ventilation,” reads the report dated October 13 which is yet to be peer reviewed.

The unit cost per patient for severe Covid-19 cases is Sh44,292 while Sh13,413 is for oxygen therapy, Sh19,835 for staffing and Sh55,224 for pharmaceuticals. The total costs ends up being Sh150, 849 and Sh12,570 without PPEs.

The report, which Health Chief Administrative Secretary Dr Mercy Mwangangi has co-authored, notes that pharmaceuticals and PPEs are the key contributors of management of patients with severe Covid-19.

“This is because more health workers are involved in the care of these patients (increasing PPE costs) and the patients receive pharmaceutical and non-pharmaceutical interventions such as antibiotics, fluids and oxygen, reads the report published by MedRxiv.

The report analyses that these costs will put fiscal strain of health systems of lower and middle income countries (LMIC) like Kenya because of existing resource challenges.

“Kenya will need to actively mobilise both domestic and donor resources to meet these costs. Second, Kenya, and other LMIC may need to adapt case management guidelines further to improve efficiencies and affordability without compromising quality of care,” it adds.