Optimizing resource allocation in United States AIDS drug assistance programs
Optimizing resource allocation in United States AIDS drug assistance programs
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DOI：
10.1086/508657
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发表时间：
2006-11-15
影响因子：
11.8
通讯作者：
Freedberg, Kenneth A.
中科院分区：
文献类型：
--
作者：
Linas, Benjamin P.;Zheng, Hui;Freedberg, Kenneth A.
背景美国获得性免疫缺陷综合症（艾滋病）药物援助计划（ADAP）为患有人类免疫缺陷病毒（HIV）感染/艾滋病的低收入患者提供药物。在国家一级，《适应行动方案》正处于财政危机之中。许多州都建立了等候名单，通常按照先到先得的原则为客户提供服务。我们假设，基于CD 4细胞计数的ADAP资格将改善ADAP的结果，使他们能够服务于更多样化的患者群体，并优先考虑那些HIV相关死亡风险最大的人。我们使用马萨诸塞州ADAP管理数据创建了一个自2003财年以来的马萨诸塞州ADAP客户的回顾性队列。然后，我们使用基于模型的分析来应用有限项目的潜在合格标准，并比较基于CD 4细胞计数和先到先得合格标准的患者特征。在2003财政年度，马萨诸塞州ADAP为3 560名客户提供服务，直接费用为1 030万美元。使用基于CD 4细胞计数的合格性（合格性标准为当前或最低CD 4细胞计数
Background. US acquired immunodeficiency syndrome (AIDS) Drug Assistance programs (ADAPs) provide medications to low-income patients with human immunodeficiency virus ( HIV) infection/AIDS. Nationally, ADAPs are in a fiscal crisis. Many states have instituted waiting lists, often serving clients on a first-come, first-served basis. We hypothesized that CD4 cell count-based ADAP eligibility would improve ADAP outcomes, allowing them to serve more-diverse patient populations and to prioritize persons who are at greatest risk of HIV-related mortality.Methods. We used Massachusetts ADAP administrative data to create a retrospective cohort of Massachusetts ADAP clients from fiscal year 2003. We then used a model-based analysis to apply potential eligibility criteria for a limited program and to compare characteristics of patients included under CD4 cell count-based and first-come, first-served eligibility criteria.Results. In fiscal year 2003, Massachusetts ADAPs served 3560 clients at a direct cost of $10.3 million. With use of CD4 cell count-based eligibility (with an eligibility criterion of a current or nadir CD4 cell count