Document Detail


The evolving cost of HIV in South Africa: changes in health care cost with duration on antiretroviral therapy for public sector patients.
MedLine Citation:
PMID:  17496562     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective costing study of 212 patients enrolled in a nongovernmental organization-supported public sector antiretroviral treatment (ART) program near Cape Town, South Africa was performed from a health care system perspective. gamma-Regression was used to analyze total costs in 3 periods: Pre-ART (median length=30 days), first 48 weeks on ART (Year One), and 49 to 112 weeks on ART (Year Two). Average cost per patient Pre-ART was $404. Average cost per patient-year of observation was $2502 in Year One and $1372 in Year Two. The proportion of costs attributable to hospital care fell from 70% Pre-ART to 24% by Year Two; the proportion attributable to ART rose from 31% in Year One to 55% in Year Two. In multivariate analysis, Pre-ART and Year One costs were significantly lower for asymptomatic patients compared with those with AIDS. Costs were significantly higher for those who died Pre-ART or in Year One. In Year Two, only week 48 CD4 cell count and being male were significantly associated with lower costs. This analysis suggests that the total cost of treatment for patients on ART falls by almost half after 1 year, largely attributable to a reduction in hospital costs.
Authors:
Guy Harling; Robin Wood
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  45     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-09-28     Revised Date:  2014-01-17    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  348-54     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use
Antiretroviral Therapy, Highly Active
Community Health Services
Costs and Cost Analysis
HIV Infections / drug therapy,  economics*
HIV-1*
Health Care Costs*
Humans
Length of Stay / economics
Male
Multivariate Analysis
Public Sector*
Retrospective Studies
South Africa
Grant Support
ID/Acronym/Agency:
1U19AI053217-01/AI/NIAID NIH HHS; R01 AI058736/AI/NIAID NIH HHS; R01AI058736-01A1/AI/NIAID NIH HHS; U19 AI053217/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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