Résumé : The HIV/AIDS pandemic is greatest in sub-Saharan Africa where the rate of hospital beds to the population is the lowest in the world, especially in rural areas. The economic crisis continues to force health administrations to reduce budgets. Poor management of decreasing resources further diminishes their cost-effectiveness, especially in hospitals. Adding the cost of existing medical care and treatment for the growing number of AIDS patients may drain hospital resources, resulting in the collapse of hospitals. Rural hospitals are likely to be the first hospitals to face this pressure. They already operate at low cost-effectiveness levels due to low occupancy rates, lack of supplies, poor logistics, and low receipt of resources which instead go to referral hospitals and urban areas. HIV infected patients occupy up to 30% of hospital beds and up to 70% of hospital beds in tuberculosis wards in Malawi, Uganda, and Zaire. The minimum mean length of stay by at least 20%. the increased time required to tend to HIV patients will likely reduce the quality and effectiveness of non-HIV-related programs, e.g., primary health care programs. There should be more intermediate level hospitals which are more inexpensive and simpler than referral hospitals to care for AIDS patients. It is imperative for hospitals to reach reasonable standards of management and decentralization to improve: reducing costs, decentralizing medical care, and supporting home-based care. Availability of an antiviral drug will further exasperate the situation, especially since it will be expensive and donors will not pay for costly items that ineffective hospitals consume and cannot monitor.
Notes : English
Site web : http://heapol.oxfordjournals.org/cgi/content/abstract/8/2/157