Estimating the cost of oral health services for 2018/19 financial year at public health facilities in two KwaZulu-Natal districts, South Africa: A retrospective study

Abstract

Aim: To estimate the cost of the provision of oral health services in the public health facilities in uMgungundlovu and eThekwini districts of KwaZulu-Natal during the financial year 2018/19. Materials and Methods: The study was a retrospective costing analysis using the provider’s perspective for estimating the cost for the period from April 1, 2018 to March 31, 2019. A mixed costing approach in which secondary data were obtained from the human resources system and the Basic Accounting System (BAS) package. Primary data that was collected at facility level included dental headcount, type of diagnosis, medication prescribed, and consumables utilized. The cost of supply for medicines were obtained for individual items commonly used by dental practitioners during consultation from the Pharmaceutical Supply Chain Management Unit. The costs are quoted in USD based on an average exchange of R13.25 per USD in 2018. Results: The total dental headcount across the 16 facilities was 206,309 for the 2018/19 financial year. The mean cost for dental outpatient curative care per patient per facility was $45.65 [95% confidence interval (CI): $32.88–$58.42]. The estimated total dental health expenditure across the Province based on an average unit cost per patient per facility equals to 0.86% (95% CI: 0.62%–1.10%) of the total provincial expenditure. Conclusion: The costs of dental outpatient curative care in the current study are higher than other studies and may be indicative of technical inefficiencies within the health system. We recommend that an audit of oral health services be conducted that could identify the technical inefficiencies and provide a platform for re-orientation of oral health service.