Abstract
Sickle cell disease (SCD) is a major public health concern in Africa. SCD healthcare expenses are covered by personal finances in the Congo due to the absence of universal public health insurance. Various strategies have been implemented to minimize this economic burden, including an outpatient management strategy. The present study evaluated the costs associated with outpatient management of uncomplicated sickle cell crises. Patients presenting to the National Sickle Cell Center's emergency room between December 2023 and February 2024 were included in this study for a total of 114 subjects with uncomplicated crises from SCD. Chief complaint, diagnosis, treatment, health insurance coverage, and cost of care were recorded for each subject. We further assessed the consistency of treatment with published standards of care. Mean patient age was 16 ± 13 years, where more than one-third were adults (36.5%). The ratio of males to females was 1.09. Only 26.2% were employed. Monthly income was lower in individuals with SCD ($310.32 ± 120.93) compared to those without SCD ($386.92 ± 471). Managing uncomplicated SCD as an outpatient costs an average of $99.86 ± 49, where medications represented 55.7% of the total expense. Sixty-six patients (57%) received prescription medications and investigation with no rational basis, resulting in an inflated cost of $15.96 per person. The present study did not demonstrate any financial benefits to managing uncomplicated SCD in outpatient settings.