Quantifying the reduction in nonmedical costs after the introduction of a rural county hospital in Ecuador Cuantificación de la reducción de los costos no médicos mediante la apertura de un hospital en un cantón rural del Ecuador

• Main Authors: David P. Gaus, Diego F. Herrera, William G. Mantyh, Rajesh P. Girdhari, Michael A. Kuskowski
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2011
• Subjects: Asentamientos rurales; hospitales rurales; financiación personal; gastos en salud; ahorro de costo; Ecuador; Rural communities; rural hospitals; personal expenditures; cost savings; health expenditures; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/c24ced0cf66d4131bfa31a30a76381e8

OBJECTIVE: This study attempts to quantify the impact of the introduction of local second-level health services on nonmedical costs (NMCs) for residents of the rural Ecuadorian county of La Maná. METHODS: NMCs for patients accessing second-level health care were assessed by using a quasi-experimental pre- and postintervention study design. In 2007, before local second-level health care services existed, and then in 2008, after the introduction of second-level health care services in the form of a county hospital, 508 patients from the county who sought second-level health care were interviewed. RESULTS: Mean NMCs per patient per illness episode were US$ 93.58 before the county hospital opened and US$ 12.62 after it opened. This difference was largely due to reductions in transport costs (US$ 50.01 vs. US$ 4.28) and food costs (US$ 25.38 vs. US$ 7.28) (P < 0.001 for each category). CONCLUSIONS: NMCs can be decreased sevenfold with the introduction of a county hospital in a rural province previously lacking second-level health care. Introduction of rural second-level health care reduces financial barriers and thus may increase access to these health services for poorer patients in rural communities. OBJETIVO: Este estudio tiene por objeto cuantificar la repercusión de la introducción de servicios de salud locales de segundo nivel sobre los costos no médicos para los residentes del cantón rural ecuatoriano de La Maná. MÉTODOS: Se evaluaron los costos no médicos de los pacientes que tuvieron acceso a atención médica de segundo nivel mediante un estudio cuasiexperimental de análisis previo y posterior a la intervención. En el 2007 (antes de que existieran servicios locales de este tipo) y en el 2008 (después de la introducción de atención médica de segundo nivel representada por el hospital del cantón) se entrevistaron a 508 pacientes del cantón que requirieron atención médica de segundo nivel. RESULTADOS: Los costos no médicos medios por paciente y por episodio de enfermedad fueron de US$ 93,58 antes de la ...