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Efficiency of the EmERGE Pathway to provide continuity of care for Spanish people living with medically stable HIV
journal contribution
posted on 2023-06-10, 01:48 authored by E J Beck, S Mandalia, P Yfantopoulos, Chris JonesChris Jones, Stephen BremnerStephen Bremner, J Whetham, F Etcheverry, L Moreno, E Gonzalez, M J Merino, A Leon, F GarciaObjective Calculate the efficiency of the EmERGE Pathway of Care for medically stable people living with HIV at the Hospital Clínic-IDIBAPS, Barcelona, Spain. Methods 546 study participants were followed between 1st July 2016 and 30th October 2019 across three HIV outpatient clinics, but the virtual clinic was closed during the second year. Unit costs were calculated, linked to mean use outpatient services per patient year, one-year before and after the implementation of EmERGE. Costs were combined with primary and secondary outcomes. Results Annual costs across HIV-outpatient services increased by 8%: €1073 (95%CI €999–€1157) to €1158 (95%CI €1084–€1238). Annual cost of ARVs was €7,557; total annual costs increased by 1% from €8430 (95%CI €8356–8514) to €8515 (95%CI €8441–8595). Annual cost for 433 participants managed in face-to-face (F2F) clinics decreased by 5% from €958 (95%CI 905–1018) to €904 (95%CI 863–945); participants transferred from virtual to F2F outpatient clinics (V2F) increased their annual cost by a factor of 2.2, from €115 (95%CI 94–139) to €251 (95%CI 219–290). No substantive changes were observed in primary and secondary outcomes. Conclusion EmERGE Pathway is an efficient and acceptable intervention. Increases in costs were caused by internal structural changes. The cost reduction observed in F2F clinics were off-set by the transfer of participants from the virtual to the F2F clinics due to the closure of the virtual clinic during the second year of the Study. Greater efficiencies are likely to be achieved by extending the use of the Pathway to other PLHIV.
History
Publication status
- Published
File Version
- Accepted version
Journal
Enfermedades Infecciosas y Microbiología ClínicaISSN
0213-005XPublisher
ElsevierExternal DOI
Event location
SpainDepartment affiliated with
- Primary Care and Public Health Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2021-11-17First Open Access (FOA) Date
2022-02-04First Compliant Deposit (FCD) Date
2021-11-16Usage metrics
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