The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Cote d'Ivoire
The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Cote d'Ivoire
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DOI：
10.1371/journal.pone.0011213
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发表时间：
2010-06-18
期刊：
影响因子：
3.7
通讯作者：
Anglaret, Xavier
中科院分区：
文献类型：
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作者：
Beauliere, Arnousse;Toure, Siaka;Anglaret, Xavier
背景资料：大型艾滋病护理项目经常补贴抗逆转录病毒（ARV）药物和CD 4检测，但患者往往必须支付其他与健康相关的药物和服务。我们估计的经济负担，家庭与艾滋病毒感染的成年人采取抗逆转录病毒疗法（ART）在Cote d 'Ivoire.Methodology/主要调查结果：我们进行了一项横断面调查。在获得知情同意后，我们采访了接受抗逆转录病毒治疗的艾滋病毒感染成年人，他们连续参加了阿比让18个艾滋病毒护理机构之一。我们收集了有关社会经济和医学特征的信息。主要经济指标是家庭支付能力（总开支减去食品开支）和保健开支。主要结果是面临灾难性卫生支出的家庭的百分比（如果卫生支出大于或等于支付能力的40%，则被定义为灾难性）。我们招募了1,190名成年人。中位CD 4计数为187/mm（3），ART的中位时间为14个月，72%的受试者为女性。平均家庭支付能力为213.7美元/月，平均卫生支出为24.3美元/月，12.3%的家庭面临灾难性的卫生支出。在卫生支出中，75.3%用于研究对象（抗逆转录病毒药物和CD 4检测，24.6%;发病事件诊断和治疗，50.1%;到艾滋病毒护理中心的交通，25.3%），24.7%用于其他家庭成员。当我们分层最近的CD 4计数，发病率事件相关的费用显着降低时，受试者有较高的CD 4 counters.Conclusions/Significance：许多家庭在科特迪瓦面临灾难性的健康支出，不归因于抗逆转录病毒药物或常规的后续测试。应制定创新计划，帮助接受抗逆转录病毒治疗的艾滋病毒感染者承担发病事件的费用。
Background: Large HIV care programs frequently subsidize antiretroviral (ARV) drugs and CD4 tests, but patients must often pay for other health-related drugs and services. We estimated the financial burden of health care for households with HIV-infected adults taking antiretroviral therapy (ART) in Cote d'Ivoire.Methodology/Principal Findings: We conducted a cross-sectional survey. After obtaining informed consent, we interviewed HIV-infected adults taking ART who had consecutively attended one of 18 HIV care facilities in Abidjan. We collected information on socioeconomic and medical characteristics. The main economic indicators were household capacity-to-pay (overall expenses minus food expenses), and health care expenditures. The primary outcome was the percentage of households confronted with catastrophic health expenditures (health expenditures were defined as catastrophic if they were greater than or equal to 40% of the capacity-to-pay). We recruited 1,190 adults. Median CD4 count was 187/mm(3), median time on ART was 14 months, and 72% of subjects were women. Mean household capacity-to-pay was $213.7/month, mean health expenditures were $24.3/month, and 12.3% of households faced catastrophic health expenditures. Of the health expenditures, 75.3% were for the study subject (ARV drugs and CD4 tests, 24.6%; morbidity events diagnosis and treatment, 50.1%; transportation to HIV care centres, 25.3%) and 24.7% were for other household members. When we stratified by most recent CD4 count, morbidity events related expenses were significantly lower when subjects had higher CD4 counts.Conclusions/Significance: Many households in Cote d'Ivoire face catastrophic health expenditures that are not attributable to ARV drugs or routine follow-up tests. Innovative schemes should be developed to help HIV-infected patients on ART face the cost of morbidity events.