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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/2319

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)
Keywords: Ethiopia
economic evaluation
cervical cancer
cost of illness
Copyright: May-2011
Date Added: 3-May-2012
Publisher: AAU
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 significant. 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.
URI: http://hdl.handle.net/123456789/2319
Appears in:Thesis - Public Health

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