Efficiency of the EmERGE Pathway to provide continuity of care for Spanish people living with medically stable HIV

Beck, E J, Mandalia, S, Yfantopoulos, P, Jones, C I, Bremner, S, Whetham, J, Etcheverry, F, Moreno, L, Gonzalez, E, Merino, M J, Leon, A and Garcia, F (2021) Efficiency of the EmERGE Pathway to provide continuity of care for Spanish people living with medically stable HIV. Enfermedades Infecciosas y Microbiología Clínica. ISSN 0213-005X

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Abstract

Objective
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.

Item Type: Article
Keywords: Cost and efficiency, Costes y eficiencia, EmERGE pathway, España, PLHIV, PVVIH, Spain, mHealth, vía EmERGE
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 17 Nov 2021 08:38
Last Modified: 04 Feb 2022 02:00
URI: http://sro.sussex.ac.uk/id/eprint/102949

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