Medical care in a tropical national reference and teaching hospital: outline study of cost-effectivenees.

During a 28-day prospective audit the cost-effectiveness of treatment in three types of medical wards in a large tropical teaching hospital was assessed. Patients with chronic diseases such as rheumatic heart disease were more expensive to treat than those with acute, curable illnesses such as malaria. It was concluded that the cost of providing treatment could not be reduced without affecting standards of medical care. The expense of running such a hospital might also be justified by its importnat function as a teaching hospital.