South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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To describe the costs of establishing and operating a home-based care (HBC) project providing palliative care for people with AIDS (PWA), and to project the full costs to the health care system of extending this care model. ⋯ Providing palliative HBC to PWAs in their last year of life using the ICHC model costs R2 840 per patient per year. Even with this level of HBC input, patients still incurred hospital costs of R2 522 and primary care clinic costs of R1 154 per patient per year. HBC costs are increased in rural areas where a vehicle is required for staff transport. HBC shows considerable potential to deal cost-effectively with growing palliative care needs in the face of the AIDS epidemic, but we need to understand better the true extent to which HBC can substitute for hospitalisation.
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To assess feeding methods chosen by mothers of babies who spent time in a neonatal unit. Factors influencing this decision were investigated. ⋯ Infants with a lower weight and gestational age, who stayed in the unit longer, were less likely to be breast-fed after discharge from the neonatal unit. The mothers' experience in the unit did not seem to alter their choice of feeding method decided upon before delivery. This suggests that efforts to promote breast-feeding in the neonatal unit were either ineffectual or inadequate. In order to remedy this situation it is necessary to keep the mother-infant pair together (lodger mothers) and to promote breast-feeding before and after delivery. It would also be necessary to train staff in the management of lactation problems.