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|Title: ||Cost and Predictors of Cost of Cervical Cancer Treatment in Patients Attending Tikur Anbessa Hospital; Addis Ababa, Ethiopia|
|Authors: ||Alemayehu, Desalegne|
|Advisors: ||Prof. Damen Haile Mariam (MD, MPH, PhD)|
cost of illness
|Copyright: ||May-2011 |
|Date Added: ||3-May-2012 |
|Abstract: ||Background: Cervical cancer is a leading cause of death from cancer among women in low-
resource settings, affecting women at a time of life when they are critical to social and economic
stability. In addition to its magnitude, the economic and quality-of-life burden of cervical cancer is
Objectives: To estimate economic burden of cervical cancer among patients and their family
members and to determine predictors for variation in patient related cost of cervical cancer.
Methods: Cost of illness study on 227 cervical cancer cases at Tikur Anbessa Hospital was
conducted. Consecutive sampling technique was used to select the study participants. We employed a
micro-costing bottom-up approach in order to estimate direct cost of cervical cancer. Indirect costs
for the study subjects and their accompanying persons were calculated in terms of productivity time
losses, using human capital approach. Societal perspective, prevalence-based model was used.
Descriptive statistics such as mean, standard deviation, median and inter-quartile range were
calculated to describe some parts of the results. Nonparametric testing; Kruskal Wallis was used to
determine the statistical significance of the differences in mean values for the four stage of cervical
cancer and other variables. Mann-Whitney test was used to determine the statistically significance
differences in mean values for the two groups (surgery, radiotherapy chemotherapy, ever admitted
etc.). Multiple liner regression analysis was employed to analyze the separate effects of the various
predictor variables on the cost of treatment.
Results: The average outpatient cost per patient for cervical cancer was Birr 5,905 ($407.2) (median
= 3,000 ($206.9)). Mean direct outpatient cost (Birr 4,845.3 ($334.2) takes the largest share
compared with the indirect counterpart (Birr 2,173.7 ($150)). The outpatient cost for almost half of
the respondent fails in a range between Birr 6,933 ($478) and Birr 1,359 ($93.7). Mean inpatient cost
for hospitalized patients was Birr 5,863.2 ($404.4). The average direct inpatient cost was Birr 4,771
($329) (74% medical costs and 26% non medical costs). The mean value for total inpatient cost for
nearly half of the respondent were in a range of Birr 7,161($493.9) and 1,936 ($133.5). For every
single day increment in inpatient hospital stay there is equivalent increment of Birr 61.5 ($4.2) on
total inpatient patient side cost.
Conclusion: Cervical cancer creates an immense economic burden on patients and their families.
Outpatient treatment cost was found to be dependent on patient residence distance from the hospital,
number of employed household members, number of facility visited and occupation. Longer duration
of inpatient hospital stay and existence of co-morbidity were associated with higher inpatient cost.|
|Appears in:||Thesis - Public Health|
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