Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study

Hdl Handle:
http://hdl.handle.net/10147/574551
Title:
Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study
Authors:
Brennan, Aline; Jackson, Arthur; Horgan, Mary; Bergin, Colm J; Browne, John P
Citation:
BMC Health Services Research. 2015 Apr 03;15(1):139
Issue Date:
3-Apr-2015
URI:
http://dx.doi.org/10.1186/s12913-015-0816-1; http://hdl.handle.net/10147/574551
Abstract:
Abstract Background It is anticipated that demands on ambulatory HIV services will increase in coming years as a consequence of the increased life expectancy of HIV patients on highly active anti-retroviral therapy (HAART). Accurate cost data are needed to enable evidence based policy decisions be made about new models of service delivery, new technologies and new medications. Methods A micro-costing study was carried out in an HIV outpatient clinic in a single regional centre in the south of Ireland. The costs of individual appointment types were estimated based on staff grade and time. Hospital resources used by HIV patients who attended the ambulatory care service in 2012 were identified and extracted from existing hospital systems. Associations between patient characteristics and costs per patient month, in 2012 euros, were examined using univariate and multivariate analyses. Results The average cost of providing ambulatory HIV care was found to be €973 (95% confidence interval €938 - €1008) per patient month in 2012. Sensitivity analysis, varying the base-case staff time estimates by 20% and diagnostic testing costs by 60%, estimated the average cost to vary from a low of €927 per patient month to a high of €1019 per patient month. The vast majority of costs were due to the cost of HAART. Women were found to have significantly higher HAART costs per patient month while patients over 50 years of age had significantly lower HAART costs using multivariate analysis. Conclusions This study provides the estimated cost of ambulatory care in a regional HIV centre in Ireland. These data are valuable for planning services at a local level, and the identification of patient factors, such as age and gender, associated with resource use is of interest both nationally and internationally for the long-term planning of HIV care provision.
Language:
en
Keywords:
HIV INFECTION; DAY CARE

Full metadata record

DC FieldValue Language
dc.contributor.authorBrennan, Alineen
dc.contributor.authorJackson, Arthuren
dc.contributor.authorHorgan, Maryen
dc.contributor.authorBergin, Colm Jen
dc.contributor.authorBrowne, John Pen
dc.date.accessioned2015-08-17T13:24:55Zen
dc.date.available2015-08-17T13:24:55Zen
dc.date.issued2015-04-03en
dc.identifier.citationBMC Health Services Research. 2015 Apr 03;15(1):139en
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-015-0816-1en
dc.identifier.urihttp://hdl.handle.net/10147/574551en
dc.description.abstractAbstract Background It is anticipated that demands on ambulatory HIV services will increase in coming years as a consequence of the increased life expectancy of HIV patients on highly active anti-retroviral therapy (HAART). Accurate cost data are needed to enable evidence based policy decisions be made about new models of service delivery, new technologies and new medications. Methods A micro-costing study was carried out in an HIV outpatient clinic in a single regional centre in the south of Ireland. The costs of individual appointment types were estimated based on staff grade and time. Hospital resources used by HIV patients who attended the ambulatory care service in 2012 were identified and extracted from existing hospital systems. Associations between patient characteristics and costs per patient month, in 2012 euros, were examined using univariate and multivariate analyses. Results The average cost of providing ambulatory HIV care was found to be €973 (95% confidence interval €938 - €1008) per patient month in 2012. Sensitivity analysis, varying the base-case staff time estimates by 20% and diagnostic testing costs by 60%, estimated the average cost to vary from a low of €927 per patient month to a high of €1019 per patient month. The vast majority of costs were due to the cost of HAART. Women were found to have significantly higher HAART costs per patient month while patients over 50 years of age had significantly lower HAART costs using multivariate analysis. Conclusions This study provides the estimated cost of ambulatory care in a regional HIV centre in Ireland. These data are valuable for planning services at a local level, and the identification of patient factors, such as age and gender, associated with resource use is of interest both nationally and internationally for the long-term planning of HIV care provision.en
dc.language.isoenen
dc.subjectHIV INFECTIONen
dc.subjectDAY CAREen
dc.titleResource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing studyen
dc.language.rfc3066enen
dc.rights.holderBrennan et al.; licensee BioMed Central.en
dc.date.updated2015-08-14T13:22:49Zen
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