HIV partner services in Kenya: a cost and budget impact analysis study.
HIV partner services in Kenya: a cost and budget impact analysis study.
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DOI：
10.1186/s12913-018-3530-y
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发表时间：
2018-09-17
影响因子：
2.8
通讯作者：
aPS Study Group
中科院分区：
文献类型：
--
作者：
Cherutich P;Farquhar C;Wamuti B;Otieno FA;Ng'ang'a A;Mutiti PM;Macharia P;Sambai B;Bukusi D;Levin C;aPS Study Group
在低收入环境中，获取联系信息、通知和检测艾滋病毒感染者的性伴侣（aPS）是一种有效的艾滋病毒检测策略，但不一定负担得起。我们应用WHO指南和国际药物经济学和结局研究学会（ISPOR）指南，分别对肯尼亚基苏穆县的艾滋病病毒检测服务（HTS）与aPS进行成本和预算影响分析。使用研究数据和时间运动研究，我们构建了一个基于Excel的工具来估计成本和预算的影响，aPS。从基苏穆县选定的设施收集成本数据。我们报告了HTS的年度总成本和单位成本，aPS的增量总成本和单位成本，以及在5年内扩大aPS的预算影响。我们还考虑了一个任务转移的情况下，使用社区卫生工作者（CHW），而不是设施为基础的卫生工作者，并进行敏感性分析，假设不同的利率的规模扩大的APS。在艾滋病毒感染指数客户中，使用护士和社区卫生工作者进行艾滋病毒检测的平均单位成本分别为每名客户25.36美元和17.86美元。在基苏穆县，使用护士和社区卫生工作者提供增强型辅助医疗服务的平均增量成本分别为每年1 092 161美元和753 547美元。与使用社区卫生工作者相比，使用护士在五个时期内扩大养老金服务的平均增量成本高出45%（分别为5，460，837美元和3，767，738美元）。五年来，护士模式的预算影响上限为1，767，863美元，其中63%和35%分别为老年人保健费用和抗逆转录病毒治疗费用。社区保健工作模式的增量成本上限为1 258 854美元，比护士模式低71.2%。预算影响对APS覆盖率的水平很敏感，范围从2014年使用CHW的30%覆盖率的28，547美元到2018年使用护士的80%覆盖率的1，267，603美元。使用护士扩展aPS对预算的影响最小，但在五年内不会节省成本。建议针对新诊断的指示病例进行aPS，并将任务转移给社区卫生工作者。本文的在线版本（10.1186/s12913-018-3530-y）包含补充材料，可供授权用户使用。
The elicitation of contact information, notification and testing of sex partners of HIV infected patients (aPS), is an effective HIV testing strategy in low-income settings but may not necessarily be affordable. We applied WHO guidelines and the International Society for Pharmaco-economics and Outcomes Research (ISPOR) guidelines to conduct cost and budget impact analyses, respectively, of aPS compared to current practice of HIV testing services (HTS) in Kisumu County, Kenya. Using study data and time motion studies, we constructed an Excel-based tool to estimate costs and the budget impact of aPS. Cost data were collected from selected facilities in Kisumu County. We report the annual total and unit costs of HTS, incremental total and unit costs for aPS, and the budget impact of scaling up aPS over a 5-year horizon. We also considered a task-shifted scenario that used community health workers (CHWs) rather than facility based health workers and conducted sensitivity analyses assuming different rates of scale up of aPS. The average unit costs for HIV testing among HIV-infected index clients was US$ 25.36 per client and US$ 17.86 per client using nurses and CHWs, respectively. The average incremental costs for providing enhanced aPS in Kisumu County were US$ 1,092,161 and US$ 753,547 per year, using nurses and CHWs, respectively. The average incremental cost of scaling up aPS over a five period was 45% higher when using nurses compared to using CHWs (US$ 5,460,837 and US$ 3,767,738 respectively). Over the five years, the upper-bound budget impact of nurse-model was US$ 1,767,863, 63% and 35% of which were accounted for by aPS costs and ART costs, respectively. The CHW model incurred an upper-bound incremental cost of US$ 1,258,854, which was 71.2% lower than the nurse-based model. The budget impact was sensitive to the level of aPS coverage and ranged from US$ 28,547 for 30% coverage using CHWs in 2014 to US$ 1,267,603 for 80% coverage using nurses in 2018. Scaling aPS using nurses has minimal budget impact but not cost-saving over a five-year period. Targeting aPS to newly-diagnosed index cases and task-shifting to community health workers is recommended. The online version of this article (10.1186/s12913-018-3530-y) contains supplementary material, which is available to authorized users.
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DOI：
10.1097/qai.0b013e3181ced126
发表时间：
2010-07
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Grabbe KL;Menzies N;Taegtmeyer M;Emukule G;Angala P;Mwega I;Musango G;Marum E
通讯作者：
Marum E
DOI：
10.1016/s2352-3018(16)30214-4
发表时间：
2017-02
期刊：
The lancet. HIV
影响因子：
--
作者：
Cherutich P;Golden MR;Wamuti B;Richardson BA;Ásbjörnsdóttir KH;Otieno FA;Ng'ang'a A;Mutiti PM;Macharia P;Sambai B;Dunbar M;Bukusi D;Farquhar C;aPS Study Group
通讯作者：
aPS Study Group
影响因子：
4.5
作者：
Sullivan, Sean D.;Mauskopf, Josephine A.;Shau, Wen-Yi
通讯作者：
Shau, Wen-Yi
DOI：
10.1097/qai.0000000000000102
发表时间：
2014-05-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Ng'ang'a A;Waruiru W;Ngare C;Ssempijja V;Gachuki T;Njoroge I;Oluoch P;Kimanga DO;Maina WK;Mpazanje R;Kim AA;KAIS Study Group
通讯作者：
KAIS Study Group
DOI：
10.1097/qai.0000000000000124
发表时间：
2014-05-01
影响因子：
3.6
作者：
Kimanga, Davies O.;Ogola, Samuel;Kim, Andrea A.
通讯作者：
Kim, Andrea A.