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. 2013 Mar 1;62(3):322-328.
doi: 10.1097/QAI.0b013e31827e8785.

Rates and cost of hospitalization before and after initiation of antiretroviral therapy in urban and rural settings in South Africa

Gesine Meyer-Rath  1 , Alana T Brennan, Matthew P Fox, Tebogo Modisenyane, Nkeko Tshabangu, Lerato Mohapi, Sydney Rosen, Neil Martinson
Affiliations

Rates and cost of hospitalization before and after initiation of antiretroviral therapy in urban and rural settings in South Africa

Gesine Meyer-Rath et al. J Acquir Immune Defic Syndr. .

Abstract

Few studies have compared hospitalizations before and after antiretroviral therapy (ART) initiation in the same patients. We analyzed the cost of hospitalizations among 3906 adult patients in 2 South African hospitals, 30% of whom initiated ART. Hospitalizations were 50% and 40% more frequent and 1.5 and 2.6 times more costly at a CD4 cell count, 100 cells/mm(3) when compared with 200–350 cells/mm(3) in the pre-ART and ART period, respectively. Mean inpatient cost per patient year was USD 117 (95%confidence interval, 85 to 158) for patients on ART and USD 72(95% confidence interval, 56 to 89) for pre-ART patients. Raising ART eligibility thresholds could avoid the high cost of hospitalization before and immediately after ART initiation.

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Conflict of interest statement

Potential Conflicts of Interest: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Figure 1A. Schematic of development of CD4 cell count and inpatient cost per patient year before and after ART initiation. ART indicates antiretroviral therapy; USD, US dollars. CD4 cell count development is modelled for a hypothetical individual, based on a summary of South African cohort studies[38]; inpatient cost is based on the mean inpatient cost per patient year by CD4 cell count stratum in this study. Figure 1B. Mean inpatient cost per patient year pre-ART and on ART in the national ART programme
Figure 1
Figure 1
Figure 1A. Schematic of development of CD4 cell count and inpatient cost per patient year before and after ART initiation. ART indicates antiretroviral therapy; USD, US dollars. CD4 cell count development is modelled for a hypothetical individual, based on a summary of South African cohort studies[38]; inpatient cost is based on the mean inpatient cost per patient year by CD4 cell count stratum in this study. Figure 1B. Mean inpatient cost per patient year pre-ART and on ART in the national ART programme
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References

    1. Beck EJ, Mandalia S, Griffith R, et al. Use and cost of hospital and community service provision for children with HIV infection at an English HIV referral centre. Pharmacoeconomics. 2000;17:53–69. - PubMed
    1. Baum SE, Morris JT, Gibbons RV, et al. Reduction in human immunodeficiency virus patient hospitalizations and nontraumatic mortality after adoption of highly active antiretroviral therapy. Military Medicine. 1999;164:609–612. - PubMed
    1. Mouton Y, Alfandari S, Valette M, et al. Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres. Federation National des Centres de Lutte contre le SIDA. AIDS. 1997;11:F101–5. - PubMed
    1. Krentz HB, Auld MC, Gill MJ. The high cost of medical care for patients who present late (CD4 <200 cells/microL) with HIV infection. HIV Med. 2004;5:93–8. - PubMed
    1. Nykamp D, Barnett CW, Lago M, et al. Cost of medication therapy in ambulatory HIV-infected patients. Ann Pharmacother. 1997;31:303–7. - PubMed

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