Document 2415
 DOCN  M94A2415
 TI    Costing and evaluating home based care in Zambia.
 DT    9412
 AU    Chela CM; Malska R; Chava T; Martin A; Mwanza A; Yamba B; van Prang E;
       Ministry of Health, Lusaka, Zambia.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):31 (abstract no. 099B/D). Unique
       Identifier : AIDSLINE ICA10/94370160
 AB    INTRODUCTION: In Zambia, bed capacity has remained constant since 1984.
       Admission of AIDS patients have increased by more than 15% annually. One
       response to the additional burden has been the development of several
       models of Home Based Care (HBC) programmes. These models vary widely in
       philosophy, infra-structure, cost, productivity and outcome. Yet
       policy-markers have no empirical information about the different models
       to support investment decisions. OBJECTIVES: The overall aim is to
       describe and analyze five models in order to understand alternative
       approaches and resulting costs and impacts. METHODS: A
       cost-effectiveness analysis of five home base care programmes was
       carried out. Net direct costs and productivity measures were computed
       and several comparable effectiveness variables measured using
       exploratory techniques including structures interviews, focus group
       discussion and time and motion studies. PRELIMINARY RESULTS: The five
       models are systematically described and presented in a conceptual
       framework used to carry out the cost-effectiveness study. While all five
       models are compared in the analysis, two distinct models are emphasized:
       Community Based Home Based Care, these are community initiatives
       predominantly run by lay persons in the community on a voluntary basis
       with support from community organizations, churches and health
       facilities. Hospital Based Home Care, this an outreach initiative by
       paid hospital staff who seek collaboration at community level. TABULAR
       DATA, SEE ABSTRACT VOLUME. CONCLUSION: Outreach Based Home Care costs
       more at any given service as compared to Community Based Home Care. The
       largest cost item in the Hospital Based Home Care is transport, followed
       by supplies and the staff salaries. In the Community Based Home Care,
       the largest cost component was supplies, followed by transport. The
       average duration per visit was longer with the Community-Based Home Care
       as compared to Hospital Based Home Care which as it may reflect cultural
       appropriateness and assistance in household activities. This study
       indicates that cost can be reduced by decentralizing home care as near
       as possible to the community for as amount affordable by communities
       with linked support. A possibility to increase coverage for care for
       AIDS patients is through Community-Based Home Care. The challenge,
       therefore, to communities and programme designers is how does one arouse
       the interest and commitment in home care within a context of increasing
       demands for better health and development.
 DE    Acquired Immunodeficiency Syndrome/*THERAPY  Cost-Benefit Analysis  Home
       Care Services/*ECONOMICS/ORGANIZATION & ADMIN  Hospital Administration
       Hospital Bed Capacity  Human  *Models, Theoretical  Voluntary Health
       Agencies  Zambia  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).