COST-EFFECTIVENESS OF MANAGING ACUTE CHILDHOOD DIARRHEA IN YUNNAN PROVINCE, PEOPLES-REPUBLIC-OF-CHINA

Most cases of acute childhood diarrhoea can be treated effectively and cheaply with oral rehydration salts and, when appropriate, with suita ble antimicrobials. But many cases instead are treated with expensive, unnecessary and potentially dangerous drugs and intravenous fluids. H ere, work in Yunnan Province (in South-Western China) is described. Re porting how village and township hospital doctors would treat hypothet ical cases, the paper documents their inclination to overtreat. It com pares the costs of such overtreatment with the costs of treating the c ases according to the WHO guidelines. The economic inefficiency of cur rent case management is confirmed. The reliance of the hospitals' fina nces on the profits from sales of drugs and materials is also recorded . The paper concludes that reform which reduces clinicians' financial dependence on the profits from the sale of drugs and materials might i mprove the efficiency of case management.