Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind

Abstract Introduction The poorest in Burkina Faso face numerous barriers to healthcare access, including financial and geographic obstacles, as well as a high burden of chronic conditions and multimorbidity. This study estimates the average cost of providing curative outpatient consultations at firs...

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Main Authors: Yvonne Beaugé, Valéry Ridde, Sidibé Souleymane, Joël Arthur Kiendrébéogo, Hoa Thi Nguyen, Emmanuel Bonnet, Manuela De Allegri
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-024-11854-8
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author Yvonne Beaugé
Valéry Ridde
Sidibé Souleymane
Joël Arthur Kiendrébéogo
Hoa Thi Nguyen
Emmanuel Bonnet
Manuela De Allegri
author_facet Yvonne Beaugé
Valéry Ridde
Sidibé Souleymane
Joël Arthur Kiendrébéogo
Hoa Thi Nguyen
Emmanuel Bonnet
Manuela De Allegri
author_sort Yvonne Beaugé
collection DOAJ
description Abstract Introduction The poorest in Burkina Faso face numerous barriers to healthcare access, including financial and geographic obstacles, as well as a high burden of chronic conditions and multimorbidity. This study estimates the average cost of providing curative outpatient consultations at first-level healthcare facilities to the poorest in Burkina Faso. It also estimates the budgetary impact of scaling up free access to these services nationwide. The findings provide essential evidence on cost structures to inform decision-makers in developing policies aimed at achieving universal health coverage and ensuring that no one is left behind. Methods We conducted a micro-costing study to estimate the economic costs of providing curative outpatient healthcare services to the poorest at first-level healthcare facilities, considering a health system perspective. We measured the consumption of capital costs (building and equipment) using survey data from 32 primary health facilities and recurrent costs (drugs and consumables) from medical records of 1380 poor patients in Diébougou district. These individuals were targeted and exempted from user fees through a community-based targeting approach. We obtained unit costs from official price lists, pharmacy registries, and expert interviews. We calculated the national budget for providing curative care services to the exempted poorest based on the average cost per first-level consultation. Results The estimated capital and recurrent costs of providing curative care services ranged between USD 0.59 - USD 0.61 and USD 2.58 - USD 5.00, respectively. The total cost ranged between USD 3.17 - USD 5.61 per first-level consultation. Providing curative care to the bottom 20% of the population, assuming 0.25 healthcare contacts per person per year, would result in an annual expense ranging from USD 2.77 M to USD 5.38 M (0.74-1.43% of the healthcare budget in 2019). With 2 healthcare contacts per person per year, costs increase to USD 22.19 M to USD 43.05 M (5.91-11.45% of the healthcare budget). Conclusion The results can inform policies aimed at expanding access to curative care for the poorest in Burkina Faso, contributing to the goals of universal health coverage and leaving no one behind. Further research is needed to enhance cost estimation and budgeting for higher-level care in the country.
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spelling doaj-art-3d52fb75fdc144d7b67d0785b48f7d852024-12-01T12:16:06ZengBMCBMC Health Services Research1472-69632024-11-012411910.1186/s12913-024-11854-8Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behindYvonne Beaugé0Valéry Ridde1Sidibé Souleymane2Joël Arthur Kiendrébéogo3Hoa Thi Nguyen4Emmanuel Bonnet5Manuela De Allegri6Heidelberg Institute of Global Health, Heidelberg University Hospital and Medical FacultyCEPED, IRD- Université Paris Cité, ERL INSERM SAGESUDEcole Doctorale de Science et Santé, LASAP, IRD (French Institute for Research on sustainable Development), AGIR, Université Joseph KI-ZERBODepartment of Public Health, Health Sciences Training and Research Unit, University Joseph Ki-ZerboHeidelberg Institute of Global Health, Heidelberg University Hospital and Medical FacultyFrench Institute for Research on Sustainable Development (IRD), UMR 215 ProdigHeidelberg Institute of Global Health, Heidelberg University Hospital and Medical FacultyAbstract Introduction The poorest in Burkina Faso face numerous barriers to healthcare access, including financial and geographic obstacles, as well as a high burden of chronic conditions and multimorbidity. This study estimates the average cost of providing curative outpatient consultations at first-level healthcare facilities to the poorest in Burkina Faso. It also estimates the budgetary impact of scaling up free access to these services nationwide. The findings provide essential evidence on cost structures to inform decision-makers in developing policies aimed at achieving universal health coverage and ensuring that no one is left behind. Methods We conducted a micro-costing study to estimate the economic costs of providing curative outpatient healthcare services to the poorest at first-level healthcare facilities, considering a health system perspective. We measured the consumption of capital costs (building and equipment) using survey data from 32 primary health facilities and recurrent costs (drugs and consumables) from medical records of 1380 poor patients in Diébougou district. These individuals were targeted and exempted from user fees through a community-based targeting approach. We obtained unit costs from official price lists, pharmacy registries, and expert interviews. We calculated the national budget for providing curative care services to the exempted poorest based on the average cost per first-level consultation. Results The estimated capital and recurrent costs of providing curative care services ranged between USD 0.59 - USD 0.61 and USD 2.58 - USD 5.00, respectively. The total cost ranged between USD 3.17 - USD 5.61 per first-level consultation. Providing curative care to the bottom 20% of the population, assuming 0.25 healthcare contacts per person per year, would result in an annual expense ranging from USD 2.77 M to USD 5.38 M (0.74-1.43% of the healthcare budget in 2019). With 2 healthcare contacts per person per year, costs increase to USD 22.19 M to USD 43.05 M (5.91-11.45% of the healthcare budget). Conclusion The results can inform policies aimed at expanding access to curative care for the poorest in Burkina Faso, contributing to the goals of universal health coverage and leaving no one behind. Further research is needed to enhance cost estimation and budgeting for higher-level care in the country.https://doi.org/10.1186/s12913-024-11854-8PoorestUniversal Health CoverageCost AnalysisBurkina FasoCurative Outpatient CareBudget Impact Analysis
spellingShingle Yvonne Beaugé
Valéry Ridde
Sidibé Souleymane
Joël Arthur Kiendrébéogo
Hoa Thi Nguyen
Emmanuel Bonnet
Manuela De Allegri
Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind
BMC Health Services Research
Poorest
Universal Health Coverage
Cost Analysis
Burkina Faso
Curative Outpatient Care
Budget Impact Analysis
title Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind
title_full Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind
title_fullStr Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind
title_full_unstemmed Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind
title_short Costing curative outpatient care for the poorest in Burkina Faso: informing universal health coverage and leaving no one behind
title_sort costing curative outpatient care for the poorest in burkina faso informing universal health coverage and leaving no one behind
topic Poorest
Universal Health Coverage
Cost Analysis
Burkina Faso
Curative Outpatient Care
Budget Impact Analysis
url https://doi.org/10.1186/s12913-024-11854-8
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