Cost of HIV and determinants of health care costs in HIV-positive patients in Germany: results of the DAGNA K3A Study
Cost of HIV and determinants of health care costs in HIV-positive patients in Germany: results of the DAGNA K3A Study
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DOI：
10.1007/s10198-012-0425-4
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发表时间：
2013-10-01
影响因子：
4.4
通讯作者：
Neumann, Anja
中科院分区：
文献类型：
--
作者：
Mostardt, Sarah;Hanhoff, Nikola;Neumann, Anja
本研究的目的是估计德国的HIV护理支出，并确定与资源使用相关的变量。我们在2006-2009年间在HIV专科门诊护理环境中进行了一项为期18个月的前瞻性多中心研究。如果患者(1)HIV阳性，(2)18岁，(3)提供书面同意，(4)没有参加另一项临床研究，则有资格参加研究；研究对象包括来自17个医疗中心的518名患者。采用微观成本法从两个角度估算了医疗成本：(1)社会总体成本；(2)法定医疗保险成本。数据是通过问卷调查获得的。从社会的角度来看，平均每年的医疗费用是23,298人，从法定医疗保险的角度来看，是19,103人，而不是19,103人。大部分费用是由抗逆转录病毒药物引起的(占总费用的80%和直接费用的89%)，而医院费用占总费用的7%。在卫生保健费用和临床变量之间发现了显著的统计相关性，较高的CD4计数和女性产生较低的费用，而更多的抗逆转录病毒经验和注射药物使用导致较高的支出(P<；0.05)。HIV感染的支出主要由药品费用驱动。我们确定了几个影响HIV治疗费用的临床变量。这些信息可以帮助决策者将有限的卫生保健资源分配给艾滋病毒护理。
The aims of this study were to estimate the expenditure for HIV-care in Germany and to identify variables associated with resource use.We performed an 18-month prospective multi-center study in an HIV specialized ambulatory care setting from 2006 to 2009.Patients were eligible for study participation if they (1) were HIV-positive, (2) were a parts per thousand yen18 years of age, (3) provided written consent and (4) were not enrolled in another clinical study; 518 patients from 17 centers were included.Health care costs were estimated following a micro-costing approach from two perspectives: (1) costs incurred to society in general, and (2) costs incurred to statutory health insurance. Data were obtained using questionnaires. Several empirical models for identifying the relationship between health care costs and independent variables, including age, gender, route of transmission and CD4 cell count at baseline, were developed.Average annual health care costs were a,not sign23,298 per patient from the societal perspective and a,not sign19,103 from the statutory health insurance perspective. Most expenses are caused by antiretroviral medication (80 % of the total and 89 % of direct costs), while hospital costs represented 7 % of total expenditure. A statistically significant association was found between health care costs and clinical variables, with higher CD4 count and female gender generating lower costs, while increased antiretroviral experience and injection drug use led to higher expenditures (P < 0.05).Expenditures for HIV-infection are driven mainly by drug costs. We identified several clinical variables influencing the costs of HIV-treatment. This information could assist policymakers when allocating limited health care resources to HIV care.