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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Costs associated with implementation of computer-assisted clinical decision support system for antenatal and delivery care: Case study of Kassena-Nankana district of northern Ghana
PLoS ONE, Volume 9, No. 9, Article e106416, Year 2014
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Description
Objective: This study analyzed cost of implementing computer-assisted Clinical Decision Support System (CDSS) in selected health care centres in Ghana. Methods: A descriptive cross sectional study was conducted in the Kassena-Nankana district (KND). CDSS was deployed in selected health centres in KND as an intervention to manage patients attending antenatal clinics and the labour ward. The CDSS users were mainly nurses who were trained. Activities and associated costs involved in the implementation of CDSS (pre-intervention and intervention) were collected for the period between 2009-2013 from the provider perspective. The ingredients approach was used for the cost analysis. Costs were grouped into personnel, trainings, overheads (recurrent costs) and equipment costs (capital cost). We calculated cost without annualizing capital cost to represent financial cost and cost with annualizing capital costs to represent economic cost. Results: Twenty-two trained CDSS users (at least 2 users per health centre) participated in the study. Between April 2012 and March 2013, users managed 5,595 antenatal clients and 872 labour clients using the CDSS. We observed a decrease in the proportion of complications during delivery (pre-intervention 10.74% versus post-intervention 9.64%) and a reduction in the number of maternal deaths (pre-intervention 4 deaths versus post-intervention 1 death). The overall financial cost of CDSS implementation was US$ 23,316, approximately US$1,060 per CDSS user trained. Of the total cost of implementation, 48% (US$11,272) was pre-intervention cost and intervention cost was 52% (US$12,044). Equipment costs accounted for the largest proportion of financial cost: 34% (US$7,917). When economic cost was considered, total cost of implementation was US$17,128-lower than the financial cost by 26.5%. Conclusions: The study provides useful information in the implementation of CDSS at health facilities to enhance health workers' adherence to practice guidelines and taking accurate decisions to improve maternal health care. © 2014 Dalaba et al.
Authors & Co-Authors
Dalaba, Maxwell Ayindenaba
Germany, Heidelberg
Universität Heidelberg
Ghana, Navrongo
Navrongo Health Research Center
Akweongo, Patricia
Ghana, Accra
University of Ghana
Williams, John
Ghana, Navrongo
Navrongo Health Research Center
Saronga, Happiness Pius
Germany, Heidelberg
Universität Heidelberg
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Tonchev, Pencho
Bulgaria, Pleven
Medical University - Pleven
Sauerborn, Rainer S.
Germany, Heidelberg
Universität Heidelberg
Mensah, Nathan Kumasenu
Ghana, Navrongo
Navrongo Health Research Center
Germany, Heidelberg
Universitätsklinikum Heidelberg
Blank, Antje
Germany, Heidelberg
Universitätsklinikum Heidelberg
Kaltschmidt, Jens
Germany, Heidelberg
Universitätsklinikum Heidelberg
Loukanova, Svetla N.
Germany, Heidelberg
Universität Heidelberg
Statistics
Citations: 24
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0106416
e-ISSN:
19326203
Research Areas
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Case Study
Study Approach
Qualitative
Study Locations
Ghana