The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period

We describe the immediate- and longer-term direct medical costs of care for individuals diagnosed with HIV at CD4 counts <350/mm3 (“late presenters”). We collected and stratified by initial CD4 count all inpatient, outpatient, and drug costs for all newly diagnosed patients accessing HIV care wit...

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Main Authors: Hartmut B. Krentz, M. John Gill
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:AIDS Research and Treatment
Online Access:http://dx.doi.org/10.1155/2012/757135
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author Hartmut B. Krentz
M. John Gill
author_facet Hartmut B. Krentz
M. John Gill
author_sort Hartmut B. Krentz
collection DOAJ
description We describe the immediate- and longer-term direct medical costs of care for individuals diagnosed with HIV at CD4 counts <350/mm3 (“late presenters”). We collected and stratified by initial CD4 count all inpatient, outpatient, and drug costs for all newly diagnosed patients accessing HIV care within Southern Alberta from 1/1/1995 to 1/1/2010. 59% of new patients were late presenters. We found significantly higher costs for late presenters, especially inpatient costs, during the first year after accessing care. Direct medical costs remained almost twice as high for late presenters in subsequent years compared to patients presenting with CD4 counts >350/mm3 despite significantly their improved CD4 counts. The sustained high cost for late presenters has implications for recent recommendations for wider routine HIV testing and the earlier initiation of cART. Earlier diagnosis and treatment, while increasing the immediate expenditures within a population, may produce both direct and indirect cost savings in the longer term.
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spelling doaj-art-3d4b2d391afc47a7a5df2ee979b825a22025-08-20T02:39:09ZengWileyAIDS Research and Treatment2090-12402090-12592012-01-01201210.1155/2012/757135757135The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year PeriodHartmut B. Krentz0M. John Gill1Southern Alberta Clinic, Sheldon M Chumir Health Centre, No. 3223, 1213-4th St SW, Calgary, AB, T2R 0X7, CanadaSouthern Alberta Clinic, Sheldon M Chumir Health Centre, No. 3223, 1213-4th St SW, Calgary, AB, T2R 0X7, CanadaWe describe the immediate- and longer-term direct medical costs of care for individuals diagnosed with HIV at CD4 counts <350/mm3 (“late presenters”). We collected and stratified by initial CD4 count all inpatient, outpatient, and drug costs for all newly diagnosed patients accessing HIV care within Southern Alberta from 1/1/1995 to 1/1/2010. 59% of new patients were late presenters. We found significantly higher costs for late presenters, especially inpatient costs, during the first year after accessing care. Direct medical costs remained almost twice as high for late presenters in subsequent years compared to patients presenting with CD4 counts >350/mm3 despite significantly their improved CD4 counts. The sustained high cost for late presenters has implications for recent recommendations for wider routine HIV testing and the earlier initiation of cART. Earlier diagnosis and treatment, while increasing the immediate expenditures within a population, may produce both direct and indirect cost savings in the longer term.http://dx.doi.org/10.1155/2012/757135
spellingShingle Hartmut B. Krentz
M. John Gill
The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period
AIDS Research and Treatment
title The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period
title_full The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period
title_fullStr The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period
title_full_unstemmed The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period
title_short The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period
title_sort direct medical costs of late presentation 350 mm3 of hiv infection over a 15 year period
url http://dx.doi.org/10.1155/2012/757135
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