The costs of HIV/AIDS care at government hospitals in Zimbabwe

According to official figures, HIV infection in Zimbabwe stood at 700 000-1 000 000 in 1995, representing 7-10% of the population, with even higher ex pected numbers in 2000. Such high numbers will have far reaching effects on the economy and the health care sector. Information on costs of treatment and ca re of HIV/AIDS patients In health facilities is necessary in order t o have an idea of the likely costs of the increasing number of HIV/AIDS pat ients. Therefore, the present study estimated the costs per in-patient day as well as per inpatient stay for patients in government health facilities in Zimbabwe with special emphasis on HIV/AIDS patients. Data collection and costing was done in seven hospitals representing variou s levels of the referral system. The costs per in-patient day and per in-pa tient stay were estimated through a combination of two methods: bottom-up c osting methodology (through an in-patient note review) to identify the dire ct treatment and diagnostic costs such as medication, laboratory tests and X-rays, and the standard step-down costing methodology to capture all the r emaining resources used such as hospital administration, meals, housekeepin g, laundry, etc. The findings of the study indicate that hospital care for HIV/AIDS patients was considerably higher than for non-HIV/AIDS patients. In five of the sev en hospitals visited, the average costs of an in-patient stay for an HIV/AI DS patient were found to be as much as twice as high as a non-HIV/AIDS pati ent. This difference could be attributed to higher direct costs per in-pati ent day (medication, laboratory tests and X-rays) as well as longer average lengths of stay in hospital for HIV/AIDS patients compared with non-infect ed patients. Therefore, the impact on hospital services of increasing numbe r of HIV/AIDS patients will be enormous.