Integrating Hepatitis B Care and Treatment with Existing HIV Services is Possible: A Cost Minimization Analysis from a Low Resource Setting
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
In recent years there has been growing interest in exploring methods by which the care
pathways for people with comorbid physical and health problems may be integrated. The success of such an
integration however would depend on several factors including feasibility, acceptability and costs
involved. Therefore, this report presents estimated provider costs associated with managing an integrated
HBV and HIV clinical pathway for patients on life-long treatment in low resource setting in Uganda.
Methods: A cost minimisation analysis from the providers perspective was done by considering financial
costs as a measure of the amount of money spent on resources used in the clinical pathways. The annual
cost per patient was simulated based on total amount of resources spent for all the patient visits to the
facility for HBV or HIV care per year.
Results: Findings showed that drugs and laboratory tests were the main drivers of costs in the pathways. A
high-volume facility (Arua regional referral hospital- ARRH) had a higher cost per patient in both clinics than
did the low volume facility (Koboko District Hospital- KDH). Variations occurred due to differences in the
carders of health workers, the infrastructure, the amounts of consumables used in the facilities. Cost per HBV
patient was $163.59 in ARRH and $145.76 in K DH while the cost per HIV patient was $176.52 in ARRH and
$173.23 in KDH. The integration resulted into total saving of $36.73 per patient per year in Arua RRH and
$17.5 in Koboko DH. The cost saving accrued from savings from personnel, fixed costs, consumables and
utilities incurred in running the standalone Hepatitis B clinic and the reduction in per HIV patient costs from
sharing of resources in the integrated pathway.
Conclusion: This analysis showed that the application of the integrated Pathway in HIV and HBV patient
management could improve hospital cost efficiency compared to operating stand-alone clinics. This could
further improve adherence to treatment by Hepatitis B patients and improve patient outcomes as HBV
patients get access to counselling services.
Description
Keywords
Cost minimisation analysis, Integrated clinical pathways, Cost efficiency
Citation
Ejalu, D. L., Mutyoba, J. N., Wandera, C., Seremba, E., Kambugu, A., Easterbrook, P., ... & Ocama, P. (2020). Integrating Hepatitis B Care and Treatment with Existing HIV Services is Possible: A Cost Minimization Analysis from a Low Resource Setting. Research Square https://doi.org/10.21203/rs.3.rs-112644/v1