Cost of image-guided percutaneous nephrostomy among cervical cancer patients at Muhimbili National Hospital in Tanzania

Abstract

Abstract Background Most cervical cancer patients in developing countries present in health facilities with an advanced disease, characterized by obstructive uropathy. This study aims to estimate the cost of an image-guided percutaneous nephrostomy (PCN), which was recently introduced at Muhimbili National Hospital to manage obstructive uropathy. Methods This was a cross-sectional study that was conducted between February and June 2021, from the provider's perspective. The study used a micro-costing approach to identify, quantify and value both capital and recurrent items consumed in the provision of services. Cost data were collected in Tanzanian shillings and converted to USD. Analysis was performed in an Excel spreadsheet (Microsoft Excel®, Microsoft Corporation). Results The estimated cost of image-guided PCN at Muhimbili National Hospital was 358.6 USD per patient. The main cost drivers were the cost of materials and supplies particularly the single-use Nephrostomy catheters, Amplatz guide wire, and Micro-puncture set. The estimated unit cost from this study is higher than the reimbursement price of 237.4 USD charged by the National Health Insurance Fund, and the 259.40 USD and 172.9 USD charged by the hospital for private and public patients, respectively. Conclusion Image-guided PCN for cervical patients is a relatively expensive procedure for a typical patient without health insurance. The study further underscores the importance of conducting costing studies to inform pricing and reimbursement decisions.