Achmea ‘duo-volunteer-expert-assignment’ at the Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania (February and May 2019)
Kilimanjaro Christian Medical Centre is located in the foothills of snow-capped, Mount Kilimanjaro. KCMC is a referral hospital that serves over 15 million people in Northern Tanzania. The hospital is a large complex with facilities for up to 800 patients with 630 hospital beds, 90 canvas beds and 40 baby incubators. Apart from patients, the hospital counts 1,300 staff members, 2,000 students, and 1,000 visitors and companions every day.
The assignment was to ‘Compare the costs of home care versus hospital care for end-of-life patients’. At present, health insurance programmes in Tanzania hardly or do not cover the cost of palliative care, morphine and home visits unless these patients receive this care at a hospital. End-of-life patients often have to travel long distances in poor conditions to receive care. As patients are often in a critical condition by then, they undergo emergency and/or intensive care treatment.
The Government is aware that this situation is more expensive than palliative home care. But before changing the policy on health insurance coverage of palliative home care, the Government needs to run a study that examines the costs of home care against the costs of care in hospital for end-of-life patients. Studies from low resource settings are non-existent while data from high resource countries are available and demonstrate this cost reduction. In the last three years KCMC Moshi has cared for over 700 patients in a palliative home care programme. Information on the healthcare administered to about 10% of these end-of-life patients is available for use in the Government’s study.
The project consisted of four phases, two of which were carried out by Achmea volunteer experts.
In February 2019, Achmea expert Rachel Bosman (Strategy & Innovation at Achmea Insurance Group) defined the methodology to conduct the study.
In line with the methodology, some of the required data was gathered by a local insurance firm employee.
In May 2019, the second Achmea volunteer, Milou Tenhagen PhD (Data Analyst at Achmea Insurance Group) checked and analysed the data, and created a model to which the KCMC can add additional data.
KCMC produced an informative report and scientific publication using the conclusions of the analysis and any additional data. The report will build the case for palliative home care.