Cost of integrating assisted partner services in HIV testing services in Kisumu and Homa Bay counties, Kenya: a microcosting study.
Cost of integrating assisted partner services in HIV testing services in Kisumu and Homa Bay counties, Kenya: a microcosting study.
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DOI：
10.1186/s12913-022-07479-4
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发表时间：
2022-01-14
影响因子：
2.8
通讯作者：
Levin C
中科院分区：
文献类型：
--
作者：
Wamuti B;Sharma M;Kariithi E;Lagat H;Otieno G;Bosire R;Masyuko S;Mugambi M;Weiner BJ;Katz DA;Farquhar C;Levin C
艾滋病毒辅助伴侣服务（aPS），或提供者通知和检测被诊断为艾滋病毒感染者的性和注射伴侣，被证明是安全，有效和具有成本效益的，并在2016年在肯尼亚的国家艾滋病毒检测服务（HTS）计划中扩大。我们估算了肯尼亚西部正在进行的aPS规模扩大项目中将aPS纳入常规HTS的成本。我们使用付款人的角度在14个设施提供APS进行微成本计算。虽然艾滋病毒检测呈阳性的男性和女性（索引客户）都提供了艾滋病毒检测，但我们只收集了女性索引客户及其男性性伴侣（MSP）的数据。我们使用基于活动的成本计算来确定关键的aPS活动，投入，资源以及货物和服务的估计财务和经济成本。我们分析了启动（2018年8月）的成本，以及aPS实施一年后的经常性成本（基苏穆：2019年8月;荷马湾：2020年1月），并对aPS活动进行了时间和运动观察。我们估计了艾滋病预防和治疗的增量成本，每个MSP追踪、检测、检测艾滋病毒阳性和抗逆转录病毒治疗的平均成本，成本份额和按设施分列的成本。总体而言，被追踪、检测、艾滋病毒检测呈阳性和接受抗逆转录病毒治疗的MSP人数分别为1 027人、869人、370人和272人。追踪、检测、检测艾滋病毒阳性和接受抗逆转录病毒治疗的每个MSP的平均单位成本分别为34.54美元、42.50美元、108.71美元和152.28美元，因州和设施客户数量而异。整合aPS的加权平均增量成本为每年每个设施7，485.97美元，经常性成本约占成本的90%。最大的成本驱动因素是人员（49%）和运输（13%）。提供者花费大约25%的HTS访问获得MSP联系信息（艾滋病毒阴性客户：54分钟中的13个;艾滋病毒阳性客户：96分钟中的20个），而每个MSP在电话和亲自跟踪上花费的中位时间分别为6分钟和2.5小时。将aPS集成到HTS时，平均设施成本将增加，增量成本主要由人员和运输驱动。有效利用医疗人员的战略对于有效、负担得起和可持续的APS至关重要。在线版本包含补充材料，可通过10.1186/s12913-022-07479-4获得。
HIV assisted partner services (aPS), or provider notification and testing for sexual and injecting partners of people diagnosed with HIV, is shown to be safe, effective, and cost-effective and was scaled up within the national HIV testing services (HTS) program in Kenya in 2016. We estimated the costs of integrating aPS into routine HTS within an ongoing aPS scale-up project in western Kenya. We conducted microcosting using the payer perspective in 14 facilities offering aPS. Although aPS was offered to both males and females testing HIV-positive (index clients), we only collected data on female index clients and their male sex partners (MSP). We used activity-based costing to identify key aPS activities, inputs, resources, and estimated financial and economic costs of goods and services. We analyzed costs by start-up (August 2018), and recurrent costs one-year after aPS implementation (Kisumu: August 2019; Homa Bay: January 2020) and conducted time-and-motion observations of aPS activities. We estimated the incremental costs of aPS, average cost per MSP traced, tested, testing HIV-positive, and on antiretroviral therapy, cost shares, and costs disaggregated by facility. Overall, the number of MSPs traced, tested, testing HIV-positive, and on antiretroviral therapy was 1027, 869, 370, and 272 respectively. Average unit costs per MSP traced, tested, testing HIV-positive, and on antiretroviral therapy were $34.54, $42.50, $108.71 and $152.28, respectively, which varied by county and facility client volume. The weighted average incremental cost of integrating aPS was $7,485.97 per facility per year, with recurrent costs accounting for approximately 90% of costs. The largest cost drivers were personnel (49%) and transport (13%). Providers spent approximately 25% of the HTS visit obtaining MSP contact information (HIV-negative clients: 13 out of 54 min; HIV-positive clients: 20 out of 96 min), while the median time spent per MSP traced on phone and in-person was 6 min and 2.5 hours, respectively. Average facility costs will increase when integrating aPS to HTS with incremental costs largely driven by personnel and transport. Strategies to efficiently utilize healthcare personnel will be critical for effective, affordable, and sustainable aPS. The online version contains supplementary material available at 10.1186/s12913-022-07479-4.
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影响因子：
3.7
作者：
George G;Chetty T;Strauss M;Inoti S;Kinyanjui S;Mwai E;Romo ML;Oruko F;Odhiambo JO;Nyaga E;Mantell JE;Govender K;Kelvin EA
通讯作者：
Kelvin EA
影响因子：
2.8
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
通讯作者：
aPS Study Group
谈到第一个90：高效的伴侣通知方法在坦桑尼亚与以前未被诊断的性伴侣联系起来。
影响因子：
4.4
作者：
Kahabuka C;Plotkin M;Christensen A;Brown C;Njozi M;Kisendi R;Maokola W;Mlanga E;Lemwayi R;Curran K;Wong V
通讯作者：
Wong V
影响因子：
3.7
作者：
Rivera AS;Hernandez R;Mag-Usara R;Sy KN;Ulitin AR;O'Dwyer LC;McHugh MC;Jordan N;Hirschhorn LR
通讯作者：
Hirschhorn LR
影响因子：
3.1
作者：
Henley, Catherine;Forgwei, Gideon;Muffih, Pius Tih
通讯作者：
Muffih, Pius Tih