University of Sussex
Browse
The cost of care for people living with stable HIV in Croatia and the efficiency of EmERGE.pdf (405 kB)

The cost of care for people living with stable HIV in Croatia and the efficiency of EmERGE

Download (405 kB)
journal contribution
posted on 2023-06-10, 04:29 authored by E J Beck, S Mandalia, P Yfantopoulos, Chris JonesChris Jones, Stephen BremnerStephen Bremner, J Whetham, I Benkovic, Š Zekan, J Begovac
Aim To estimate the cost-effectiveness of the EmERGE Pathway of Care for medically stable people living with HIV (PLHIV) at the University Hospital for Infectious Diseases (UHID), Zagreb. The Pathway includes a mobile application enabling individuals to communicate with their caregivers. Methods This study involving 293 participants collected data on the use of HIV outpatient services one year before and after EmERGE implementation. In departments supporting HIV outpatients, a micro-costing exercise was performed to calculate unit costs. These were combined with mean use of HIV services per patient year (MPPY) to estimate average annual costs. Primary outcomes were CD4 count, viral load, and secondary outcomes were patient activation, PAM13; and quality of life, PROQOL-HIV. Information on out-of-pocket expenditures was also collected. Results Outpatient visits decreased by 17%, from 4.0 (95% CI 3.8-4.3) to 3.3 MPPY (95% CI 3.1-3.5). Tests, including CD4 count, decreased, all contributing to a 33% reduction of annual costs: 7139 HRK (95% CI 6766-7528) to 4781 HRK (95% CI 4504-5072). Annual costs including anti-retroviral drugs (ARVs) decreased by 5%: 43 101 HRK (95% CI 42 728-43,490) to 40 743 HRK (95% CI 40 466-41,034). ARVs remain the main cost driver in stable PLHIV. Primary and secondary outcomes did not change substantially between periods. Conclusion EmERGE Pathway was a cost-saving intervention associated with changes in management, and a reduction in outpatient visits, tests, and costs. ARV costs dominated costs. Future efficiencies are possible if EmERGE is introduced to other PLHIV across the UHID and if ARV prices are reduced.

History

Publication status

  • Published

File Version

  • Published version

Journal

Croatian Medical Journal

ISSN

0353-9504

Publisher

University of Zagreb

Issue

6

Volume

62

Page range

542-552

Event location

Croatia

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2022-08-18

First Open Access (FOA) Date

2022-08-18

First Compliant Deposit (FCD) Date

2022-08-18

Usage metrics

    University of Sussex (Publications)

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC