The burden of HIV-related illness on outpatient health services in KwaZulu-Natal, South Africa

Health services in sub-Saharan Africa will be faced with increasing numbers of AIDS patients for many years to come. Where there is good availability of drugs and other resources, the costs of treating HIV/AIDS is likely to be higher than those of treating other types of illness. This will put services under strain and potentially jeopardise health system reform, depending on the vulnerability of the system. Whereas previous research has focussed on inpatients, this paper looks at the impact of HIV/AIDS on outpatient services in a district of South Africa. Through facility visits at various levels of care, data concerning HIV status and the costs of care was collected for all patients presenting over a set period of time. The proportion of patients presenting for HIV-related care ranged from 20.2 to 24.5%. The average costs of treating HIV-positive patients were significantly higher than those for non HIV patients at hospitals, with clinics not experiencing this difference due to the limited service provided. District hospitals spent the greatest proportion of direct patient care resources on treating HIV-related illness. In terms of outpatient care, this data suggests that district hospitals may require the most support in dealing with a rising number of AIDS patients.