How good are US studies of HIV costs of care?

How good are US studies of HIV costs of care?
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美国对艾滋病毒护理费用的研究有多好?

DOI:
10.1097/00005650-199908000-00005
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发表时间:
1999
期刊:
影响因子:
3
通讯作者:
N. Wray
N. Wray
中科院分区:
医学3区
文献类型:
--
作者:
L. Rabeneck;T. Menke;N. Wray

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背景 卫生规划者和决策者需要对艾滋病毒护理费用进行有效、及时的估计。 目的 对已发表的HIV护理资源利用和成本估计进行方法学评价。 数据源 1990 - 1998年MEDLINE数据库。 数据选择 纳入的文章侧重于患有一系列艾滋病毒疾病的成年人,其中作者开发了自己的资源使用和成本数据。31篇文章符合这些标准。 数据提取 比较研究的基础是:(1)利用率和成本估计,以1995年美元计算;(2)研究周期;(3)研究设计;(4)抽样框架;(5)样本大小和患者特征;(6)数据来源和服务范围;(7)分析中使用的方法。 资料综合 最近的估计数是1995年上半年,即在使用蛋白酶抑制剂疗法之前。我们发现估计值存在很大差异,并确定了三个主要来源:(1)仅限于全国艾滋病毒感染人群亚组的患者样本;(2)范围有限的使用数据(例如,仅住院治疗);(3)估算年度或终生成本的方法无效,特别是在处理死者时。 结论 为了准确估计全国艾滋病毒护理的资源使用和成本,需要一个具有全国代表性的艾滋病毒感染者概率样本。即使在不打算提供国家估计数的研究中,也应当扩大利用数据的范围,并需要更加注意分析年度和寿命期费用的方法问题。
BACKGROUND Valid, timely estimates of the costs of HIV care are needed by health planners and policy makers. OBJECTIVE To perform a methodologic critique of published estimates of resource utilization and costs of HIV care. DATA SOURCES MEDLINE database for 1990-1998. DATA SELECTION Included articles focused on adults with a spectrum of HIV disease in which the authors developed their own resource use and cost data. Thirty one articles met these criteria. DATA EXTRACTION Studies were compared based on: (1) utilization and cost estimates, in 1995 dollars; (2) study period; (3) research design; (4) sampling frame; (5) sample size and patient characteristics; (6) data sources and scope of services; and (7) methods used in the analysis. DATA SYNTHESIS The most recent estimates pertain to the first half of 1995, before the use of protease inhibitor therapy. We found wide variations in the estimates and identified three major sources for this: (1) patient samples that were restricted to subgroups of the national HIV-infected population; (2) utilization data that were limited in scope (e.g., inpatient care only); and (3) invalid methods for estimating annual or lifetime costs, particularly in dealing with decedents. CONCLUSIONS To accurately estimate resource use and costs for HIV care nationwide, a nationally representative probability sample of HIV-infected patients is required. Even in research that is not intended to provide national estimates, the scope of utilization data should be broadened and greater attention to methodologic issues in the analysis of annual and lifetime costs is needed.
新泽西州对获得性免疫缺陷综合症的医疗补助豁免。
DOI: --
发表时间: 1992
影响因子: --
作者:
Merzel,C;Crystal,S;Sambamoorthi,U;Karus,D;Kurland,C
通讯作者: Kurland,C
DOI: --
发表时间: 1993
期刊: Journal of acquired immune deficiency syndromes
影响因子: --
作者:
Seage3rd,GR;Hertz,T;Stone,VE;Epstein,AM
通讯作者: Epstein,AM
马里兰州城市艾滋病毒感染者群体中推进免疫抑制的医疗补助费用。
DOI: 10.1097/00042560-199703010-00005
发表时间: 1997
期刊: Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association
影响因子: --
作者:
Moore,RD;Chaisson,RE
通讯作者: Chaisson,RE