title: The direct cost of care among surgical inpatients at a tertiary hospital in south west Nigeria.
abstract: BACKGROUND
  This study was conducted to assess the direct cost of care and its determinants among surgical inpatients at university College Hospital, Ibadan.
  
  
  METHODS
  A retrospective review of records of 404 inpatients that had surgery from January to December, 2010 was conducted. Information was extracted on socio-demographic variables, investigations, drugs, length of stay (LOS) and cost of care with a semi-structured pro-forma. Mean cost of care were compared using t-test and Analysis of variance (ANOVA). Linear regression analysis was used to identify determinants of cost of care. Level of significance of 5% was used. In year 2010 $1 was equivalent to 150 naira ($1=₦ 150).
  
  
  RESULTS
  The median age of patients was 30 years with inter-quartile range of 13-42 years. Males were 257(63. 6%). The mean overall cost of care was ₦66,983±₦31,985. Cost of surgery is about 50% of total cost of care. Patient first seen at the Accident and Emergency had a significantly higher mean cost of care of ß=₦17,207(95% CI: ₦4,003 to ₦30,410). Neuro Surgery (ß=₦36,210), and Orthopaedic Surgery versus General Surgery(ß=₦10,258),and Blood transfusion (ß=₦18,493) all contributed to cost of care significantly. Increase of one day in LOS significantly increased cost of care by ₦2,372. 57.
  
  
  CONCLUSIONS
  The evidence evaluated here shows that costs and LOS are interrelated. Attempt at reducing LOS will reduce the costs of care of surgical inpatient.
authors.affiliation: Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: Olayinka Stephen
authors.initials: OS
authors.lastname: Ilesanmi
authors.affiliation: Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Akinola Ayoola
authors.initials: AA
authors.lastname: Fatiregun
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D009549:Nigeria; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000191:economics*; D062606:Tertiary Care Centers / Q000191:economics; D055815:Young Adult
keywords: Cost; anaesthesia; health care; hospital bill; hospital length of stay; resource; surgery