How govt spends Shs3m on each Covid-19 patient

The government is spending nearly the same amount of money, and occasionally more, to treat critically-ill Covid-19 patients as do private hospitals despite public uproar over billing by the latter.

While briefing MPs last week, the Health minister, Dr Jane Aceng, said it costs up to Shs3 million a day to treat Covid patients in Intensive Care Units (ICU).

“We engaged a consultant to calculate for us the cost of managing a patient in our ICU in Mulago [National Referral Hospital]. Incidentally, the costs are not different from that of the private sector. Every patient in Intensive Care Unit takes about Shs3m per day and those in HDU (High Dependency Unit) take Shs788,516 per day,” she said.

The quoted rates compare with average charges at private hospitals, except the high-end facilities that bill Shs5m daily, starting with a Shs10m initial down payment.

Testimonies that some private hospitals charged in excess of Shs100m for patients admitted for  a longer time , and in some cases retaining documents of property, sparked public outrage.

 It prompted National Social Security Fund  to allow its critically-ill members to access their savings.

Court last week ordered the government to regulate the charges in private facilities following a petition by health activists.
Just like private hospitals, Dr Aceng said most of its daily spending caters for medicines, personal protective equipment (PPEs), risk allowances for staff, and treating comorbidities.

The government’s computation shows that on average, it spends Shs22m to treat a hospitalised Covid-19 patient for the entire treatment duration.

The Uganda Healthcare Federation (UHF),  an umbrella body of private hospitals, last week said its members spend about the Shs3.5 million a day on a Covid-19 patient.

Asked yesterday to justify the Shs3m charged in public facilities, Dr Charles Olaro, the director of clinical services (curative), said: “For critical cases in ICU, payment for personnel takes 5 per cent [Shs150,000], medicine takes about 28 per cent [Sh840,000] and supplies such as PPEs, laboratory test kits and other consumables take around 33 per cent [Shs990,000].”
Dr Olaro said many patients also have varying complications.

Complications
“You find that 63 per cent of the patients admitted to the ICU have hypertension, 20 per cent have arrhythmia (heart complications), and others have neurological disease and 14 per cent will develop acute kidney injury during the course of the disease,” he said.

Dr Olaro said the hospital also spends on feeding the patient and transporting oxygen cylinders.
The billing at public facilities, official records show, are based on costing medicines supplied by National Medical Stores, salaries and risk allowances that government is paying health workers and other support from development partners and well-wishers.

In contrast, last week, the UHF said of the Shs3.5m cost private hospitals meet to treat a patient in ICU each day, Shs1.15m is spent on drugs, Shs805,000 on human resources while bedding and ventilators take Shs560,000. 

The federation said laboratory tests, PPEs, consumables and administration cost  Shs1,050,000.

Dr Samuel Opio, the secretary of the Pharmaceutical Society of Uganda, said the dose of Covid-19 medicine (Remdesivir) for treating a hospitalised patient costs around Shs2.5m.

Item and Cost 

• Drugs    Shs840,000
• PPEs and Consumables    Shs990,000
• Human Resource    Shs150,000
• Other complications, feeding, and transporting oxygen    Shs1,020,000