SAHR 2007 - Health Systems Trust

Health and Related Indicators 15
Table 52: Cost per PDE by province, 2005/06 and 2006/07 (nominal prices)
Health Financing – Public sector
EC FS GP KZN LP MP NC NW WC SA
2005/6 731 860 902 834 926 973 949 - 662 834
2006/7 839 896 1 181 897 1 051 1 086 1 205 884 843 954
Sources:
Calculated from BAS data (National Treasury) and financial data
from NW province, DHIS.
Target for 2005/6 = R793 [IGFR 2006], target for 2006/7 = R814
(Health District Development & Performance Assessment Tools.
National Department of Health; March 2007).
The Treasury has computed the unit costs per primary
care visit (including the contribution from local government
funding) and shown that this has increased, in nominal terms,
from an average of R64 per visit in 2000/01 to an average
of R95 per visit in 2005/06. It has expressed concern at the
“mixed evidence of success”, noting, for example, that while
“immunisation coverage rates are high, TB cure rates remain
low”.
In contrast to the private sector, hospital admission rates
have remained fairly constant, estimated at 93 per 1 000
uninsured lives in 2005/06. Hospital outpatient and casualty
visits remain high, at 501 per 1 000 uninsured lives in
2005/06. Determining costs per admission for different levels
of hospital are complicated by the fact that hospitals often
offer services different from their nominal status (e.g. regional
hospitals offering some tertiary services). A target of R4 000
to R5 000 per admission at regional hospitals has been
suggested, but current data show wide variation, from less
that R3 000 to more than R10 000. The report states that
the national cost per patient day equivalent (PDE) at district
hospitals was R1 827, at regional hospitals R3 336, and at
central hospitals R4 868, significantly exceeding the given
targets of R793, R1 099 and R1 860 respectively. However
recent analysis of the cost per PDE for individual district
hospitals suggests that the actual values are closer to the
national targets (Table 52).
Table 53: Health financing indicators by province
EC FS GP KZN LP MP NC NW WC SA
Claims ratio
2003 - - - - - - - - - 79.2 a
2004 - - - - - - - - - 78.6 b
2005 - - - - - - - - - 84.4 c
2006 88.0 d
Health expenditure % of GDP
2005 Private sector - - - - - - - - - 4.6 e
2005 Public sector - - - - - - - - - 3.5 e
2005 Total - - - - - - - - - 8.1 e
Medical scheme beneficiaries
2003 - - - - - - - - - 6 924 686 a
2004 595 826 318 822 2 579 404 1 028 600 279 658 454 208 152 333 312 930 1 193 885 6 915 666 b
2005 601 154 326 151 2 535 991 1 038 174 261 955 468 066 143 971 334 919 1 119 247 6 835 621 f
2006 614 197 341 549 2 593 809 1 091 744 300 856 492 387 149 399 365 692 1 157 483 7 127 343 d
Medical scheme coverage
2003 - - - - - - - - - 14.9 a
2004 8.4 10.8 29.2 10.6 5.1 14.0 16.9 8.2 26.1 14.8 b
2005 8.5 11.0 28.1 10.8 4.7 14.5 16.0 8.8 24.1 14.6 f
2006 8.7 11.5 28.2 11.2 5.3 15.1 16.4 9.5 24.4 15.0 d
2004 GHS 9.6 14.9 26.2 11.3 6.4 12.2 14.2 11.8 25.9 14.9 g
2005 GHS 9.8 13.9 22.5 11.4 6.7 10.5 15.6 11.1 22.4 14.0 g
2006 GHS 10.2 14.8 21.8 10.8 6.7 11.2 13.5 13.5 18.8 13.7 g
Pensioner ratio
2003 - - - - - - - - - 6.3 a
2004 - - - - - - - - - 6.7 b
2005 - - - - - - - - - 6.4 h
2006 6.3 d
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