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Table 1 Breakdown of costs and details of calculations

From: Cost of hospital care of women with postpartum haemorrhage in India, Kenya, Nigeria and Uganda: a financial case for improved prevention

Description Calculation
Medical and surgical interventions (I) Cost of disposable apparel (gowns, gloves, caps etc.) + disposable consumables (needles, gauze, syringes etc.) + instruments (sterilization fee) + cleaning + laboratory tests + fee for use of operating theatre (if applicable) + staff labour cost (L)
Each surgical intervention was costed as an independent intervention, although some patients may have received more than one intervention concurrently with some costs shared across interventions
Staff labour during interventions (L) Monthly salary/hours worked per month x hours devoted to intervention
Calculated for all personnel required for the procedure
Drug tray (DT) Total price of the full tray of drugs available for the surgical intervention
Blood transfusion (B) First unit of blood: Cost of apparel + consumables + sterilization charge + laboratory tests + blood product price + cost of labour for blood (LB)
Each additional unit of blood: Cost of labour for blood (LB) + blood product price
Hospital stay (HS) Basic cost of 24 h stay in ward bed x the number of days in hospital from the time of birth to discharge
Some patients were discharged within 24 h and with no additional care over basic delivery services. As we did not calculate the cost of delivery specifically (it occurs prior to diagnosis of PPH) these patients’ records would show zero cost. To avoid this, all patients were allocated a minimum of 1 day’s hospital stay as a proxy for the cost of delivery
Additional uterotonics (AU) Price of the dose of the uterotonic administered, being either:
the price of the individual unit (i.e. tablet, ampoule) multiplied by the units administered or
the pack price divided by units in the pack multiplied by the units administered
Concomitant medicines (CM) Price of the dose of the medicine administered, being either:
the price of the individual unit (i.e. tablet, ampoule) multiplied by the units administered or
the pack price divided by units in the pack multiplied by the units administered
Concomitant formula T2 = HS + ΣI + U + B + CM T2 = Total cost of care
HS = Cost of hospital stay
I = Costs of a surgical intervention received for treatment of PPH and ΣI = the sum of costs of all surgical interventions received
U = Sum of the cost of all additional uterotonics administered for treatment of PPH
B = Cost of blood and blood products administered
CM = Sum of cost of all concomitant medicines administered
Drug tray formula T3 = HS + Σ(I + DT) + U + B HS = Cost of hospital stay
I = Costs of a surgical intervention received for treatment of PPH and DT = Cost of the full tray of drugs available for each surgical intervention for PPH treatment
U = Sum of the cost of all additional uterotonics administered for treatment of PPH
B = Cost of blood and blood products administered
  1. The data for concomitant medicines administered during the CHAMPION trial included an extensive list of medicines, many of which were not related to PPH care. It was not possible to isolate the drugs that were administered specifically for the treatment of PPH from the list of concomitant drugs. The cost of the drugs available for each surgical intervention was also collected to complement the cost information. Investigators from each of the countries were requested to list all the drugs used to treat PPH. This list developed per country was named ‘drug tray’ for the purposes of this study
  2. The Drug Tray formula was used to validate the results by addressing the uncertainty about the concomitants being related to PPH or not. For the Drug Tray formula, it should be noted that the entirety of the drug tray may not have been used for each intervention depending on each patient’s medical condition. It was not logistically possible to cross-match the concomitants and drug tray data to achieve a more accurate result