AEGiS-13IAC: Extra budget is not the key to increasing the potential of community hospitals in AIDS care in developing countries.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Extra budget is not the key to increasing the potential of community hospitals in AIDS care in developing countries.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrB123)

Panthawit S
S. Panthawit, Bang Kruai District Hospital, 311 Latphrao Road, Soi 101, Bangkok 10240, Thailand, Tel.: +66 2 357 6491, Fax: +66 2 374 9835, E-mail: msfbthai@asianet.co.th

ISSUES: HIV/AIDS care in Community Hospitals in developing countries is limited by budget and ability to investigate some opportunistic infections. Patients and their families have to seek for care to bigger and more distant hospitals. The difficulty and cost of transportation is many times more expensive than the treatment they receive and the bigger hospitals are overloaded with patients.

DESCRIPTION: To solve these problems by increase in budget or equipment would need discussion at policy level. There would be many issues to be discussed, including feasability and cost effectiveness. Another approach can be taken by the community hospital - developing or strengthening the referral system and networking. Bang Kruai Hospital is a 30-bed community hospital in Bangkok, Thailand and has provided a continuum of care for PHA with complicated opportunistic infections by cooperation with a referral hospital (Bamrasnaradura Hospital). During 18 months (November 1997 to April 1999) 26 cases of cryptococcal meningitis, cerebral toxoplasmosis, MAC and other complicated opportunistic infections were referred to the higher level for diagnosis and advice about treatment. Three cases of simpler opportunistic infections were referred from the higher level to the community.

CONCLUSIONS: Community Hospitals can contribute to the continuum of care of PHA by cooperation with a higher level hospital, home care team, health stations, health volunteers, families and NGOs. Management changes and improved information flow in the higher level hospital are necessary to increase its potential to refer PHA to the community level.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Developing Countries, Budgets, HIV Infections, Hospitals, Community, Hospitals, Cost-Benefit Analysis, Meningitis, Cryptococcal, Health Services Needs and Demand, Community Health Services, Toxoplasmosis, Cerebral, Social Support, Thailand, Human, economics, therapy
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MoOrB123