Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost?
Abstract Essential Emergency and Critical Care (EECC) is a novel approach to the care of critically ill patients, focusing on first-tier, effective, low-cost, life-saving care and designed to be feasible even in low-resourced and low-staffed settings. This is distinct from advanced critical care, us...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | Cost Effectiveness and Resource Allocation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12962-023-00425-z |
| _version_ | 1797864584825012224 |
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| author | Lorna Guinness Angela Kairu August Kuwawenaruwa Karima Khalid Khamis Awadh Vincent Were Edwine Barasa Hiral Shah Peter Baker Carl Otto Schell Tim Baker |
| author_facet | Lorna Guinness Angela Kairu August Kuwawenaruwa Karima Khalid Khamis Awadh Vincent Were Edwine Barasa Hiral Shah Peter Baker Carl Otto Schell Tim Baker |
| author_sort | Lorna Guinness |
| collection | DOAJ |
| description | Abstract Essential Emergency and Critical Care (EECC) is a novel approach to the care of critically ill patients, focusing on first-tier, effective, low-cost, life-saving care and designed to be feasible even in low-resourced and low-staffed settings. This is distinct from advanced critical care, usually conducted in ICUs with specialised staff, facilities and technologies. This paper estimates the incremental cost of EECC and advanced critical care for the planning of care for critically ill patients in Tanzania and Kenya. The incremental costing took a health systems perspective. A normative approach based on the ingredients defined through the recently published global consensus on EECC was used. The setting was a district hospital in which the patient is provided with the definitive care typically provided at that level for their condition. Quantification of resource use was based on COVID-19 as a tracer condition using clinical expertise. Local prices were used where available, and all costs were converted to USD2020. The costs per patient day of EECC is estimated to be 1 USD, 11 USD and 33 USD in Tanzania and 2 USD, 14 USD and 37 USD in Kenya, for moderate, severe and critical COVID-19 patients respectively. The cost per patient day of advanced critical care is estimated to be 13 USD and 294 USD in Tanzania and USD 17 USD and 345 USD in Kenya for severe and critical COVID-19 patients, respectively. EECC is a novel approach for providing the essential care to all critically ill patients. The low costs and lower tech approach inherent in delivering EECC mean that EECC could be provided to many and suggests that prioritizing EECC over ACC may be a rational approach when resources are limited. Graphical Abstract |
| first_indexed | 2024-04-09T22:55:23Z |
| format | Article |
| id | doaj.art-b8cd51eae67c4ed0b8af29ae416de505 |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-04-09T22:55:23Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-b8cd51eae67c4ed0b8af29ae416de5052023-03-22T11:20:30ZengBMCCost Effectiveness and Resource Allocation1478-75472023-02-0121111210.1186/s12962-023-00425-zEssential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost?Lorna Guinness0Angela Kairu1August Kuwawenaruwa2Karima Khalid3Khamis Awadh4Vincent Were5Edwine Barasa6Hiral Shah7Peter Baker8Carl Otto Schell9Tim Baker10Center for Global DevelopmentHealth Economics Research Unit, KEMRI Wellcome Trust Research ProgrammeIfakara Health InstituteIfakara Health InstituteIfakara Health InstituteHealth Economics Research Unit, KEMRI Wellcome Trust Research ProgrammeHealth Economics Research Unit, KEMRI Wellcome Trust Research ProgrammeCenter for Global DevelopmentCenter for Global DevelopmentDepartment of Global Public Health, Karolinska InstitutetIfakara Health InstituteAbstract Essential Emergency and Critical Care (EECC) is a novel approach to the care of critically ill patients, focusing on first-tier, effective, low-cost, life-saving care and designed to be feasible even in low-resourced and low-staffed settings. This is distinct from advanced critical care, usually conducted in ICUs with specialised staff, facilities and technologies. This paper estimates the incremental cost of EECC and advanced critical care for the planning of care for critically ill patients in Tanzania and Kenya. The incremental costing took a health systems perspective. A normative approach based on the ingredients defined through the recently published global consensus on EECC was used. The setting was a district hospital in which the patient is provided with the definitive care typically provided at that level for their condition. Quantification of resource use was based on COVID-19 as a tracer condition using clinical expertise. Local prices were used where available, and all costs were converted to USD2020. The costs per patient day of EECC is estimated to be 1 USD, 11 USD and 33 USD in Tanzania and 2 USD, 14 USD and 37 USD in Kenya, for moderate, severe and critical COVID-19 patients respectively. The cost per patient day of advanced critical care is estimated to be 13 USD and 294 USD in Tanzania and USD 17 USD and 345 USD in Kenya for severe and critical COVID-19 patients, respectively. EECC is a novel approach for providing the essential care to all critically ill patients. The low costs and lower tech approach inherent in delivering EECC mean that EECC could be provided to many and suggests that prioritizing EECC over ACC may be a rational approach when resources are limited. Graphical Abstracthttps://doi.org/10.1186/s12962-023-00425-zCritical careCOVID-19CostKenyaTanzaniaSub-Saharan Africa |
| spellingShingle | Lorna Guinness Angela Kairu August Kuwawenaruwa Karima Khalid Khamis Awadh Vincent Were Edwine Barasa Hiral Shah Peter Baker Carl Otto Schell Tim Baker Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost? Cost Effectiveness and Resource Allocation Critical care COVID-19 Cost Kenya Tanzania Sub-Saharan Africa |
| title | Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost? |
| title_full | Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost? |
| title_fullStr | Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost? |
| title_full_unstemmed | Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost? |
| title_short | Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost? |
| title_sort | essential emergency and critical care as a health system response to critical illness and the covid19 pandemic what does it cost |
| topic | Critical care COVID-19 Cost Kenya Tanzania Sub-Saharan Africa |
| url | https://doi.org/10.1186/s12962-023-00425-z |
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