Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study

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dc.contributor.author Brennan, Aline
dc.contributor.author Jackson, Arthur
dc.contributor.author Horgan, Mary
dc.contributor.author Bergin, Colm
dc.contributor.author Browne, John P.
dc.date.accessioned 2016-01-18T16:37:53Z
dc.date.available 2016-01-18T16:37:53Z
dc.date.issued 2015-04-03
dc.identifier.citation BRENNAN, A., JACKSON, A., HORGAN, M., BERGIN, C. J. & BROWNE, J. P. 2015. Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study. BMC Health Services Research, 15: 139, 1-10. http://dx.doi.org/10.1186/s12913-015-0816-1 en
dc.identifier.volume 15 en
dc.identifier.startpage 1 en
dc.identifier.endpage 10 en
dc.identifier.issn 1472-6963
dc.identifier.uri http://hdl.handle.net/10468/2193
dc.identifier.doi 10.1186/s12913-015-0816-1
dc.description.abstract BACKGROUND: It is anticipated that demands on ambulatory HIV services will increase in coming years as a consequence of the increased life expectancy of HIV patients on highly active anti-retroviral therapy (HAART). Accurate cost data are needed to enable evidence based policy decisions be made about new models of service delivery, new technologies and new medications. METHODS: A micro-costing study was carried out in an HIV outpatient clinic in a single regional centre in the south of Ireland. The costs of individual appointment types were estimated based on staff grade and time. Hospital resources used by HIV patients who attended the ambulatory care service in 2012 were identified and extracted from existing hospital systems. Associations between patient characteristics and costs per patient month, in 2012 euros, were examined using univariate and multivariate analyses. RESULTS: The average cost of providing ambulatory HIV care was found to be €973 (95% confidence interval €938 - €1008) per patient month in 2012. Sensitivity analysis, varying the base-case staff time estimates by 20% and diagnostic testing costs by 60%, estimated the average cost to vary from a low of €927 per patient month to a high of €1019 per patient month. The vast majority of costs were due to the cost of HAART. Women were found to have significantly higher HAART costs per patient month while patients over 50 years of age had significantly lower HAART costs using multivariate analysis. CONCLUSIONS: This study provides the estimated cost of ambulatory care in a regional HIV centre in Ireland. These data are valuable for planning services at a local level, and the identification of patient factors, such as age and gender, associated with resource use is of interest both nationally and internationally for the long-term planning of HIV care provision. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Biomed Central Ltd. en
dc.rights © 2015 Brennan et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject HIV en
dc.subject Micro-costing en
dc.subject Cost en
dc.subject Healthcare utilisation en
dc.subject Ambulatory care en
dc.subject Outpatient care en
dc.subject Highly active antiretroviral therapy en
dc.title Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother John Patrick Browne, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: j.browne@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.internal.rssid 325359490
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Health Services Research en
dc.internal.copyrightchecked Open Access articles licensed via CC-BY 4.0 with UCC affiliated authors. Uploaded Jan 2016. en
dc.internal.IRISemailaddress j.browne@ucc.ie en
dc.identifier.articleid 139


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© 2015 Brennan et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © 2015 Brennan et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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