Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua
Background. A 2010 evaluation found generally poor outcomes among HIV patients on antiretroviral therapy in Nicaragua. We evaluated an intervention to improve HIV nursing services in hospital outpatient departments to improve patient treatment and retention in care. The intervention included improvi...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Nursing Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2014/232046 |
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| author | Edward Broughton Danilo Nunez Indira Moreno |
| author_facet | Edward Broughton Danilo Nunez Indira Moreno |
| author_sort | Edward Broughton |
| collection | DOAJ |
| description | Background. A 2010 evaluation found generally poor outcomes among HIV patients on antiretroviral therapy in Nicaragua. We evaluated an intervention to improve HIV nursing services in hospital outpatient departments to improve patient treatment and retention in care. The intervention included improving patient tracking, extending clinic hours, caring for children of HIV+ mothers, ensuring medication availability, promoting self-help groups and family involvement, and coordinating multidisciplinary care. Methods. This pre/postintervention study examined opportunistic infections and clinical status of HIV patients before and after implementation of changes to the system of nursing care. Hospital expenditure data were collected by auditors and hospital teams tracked intervention expenses. Decision tree analysis determined incremental cost-effectiveness from the implementers’ perspective. Results. Opportunistic infections decreased by 24% (95% CI: 14%–34%) and 11.3% of patients improved in CDC clinical stage. Average per-patient costs decreased by $133/patient/year (95% CI: $29–$249). The intervention, compared to business-as-usual strategy, saved money while improving outcomes. Conclusions. Improved efficiency of services can allow more ART-eligible patients to receive therapy. We recommended the intervention be implemented in all HIV service facilities in Nicaragua. |
| format | Article |
| id | doaj-art-3f9a60928cee424dbfe2c7596ae9edc3 |
| institution | Kabale University |
| issn | 2090-1429 2090-1437 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Nursing Research and Practice |
| spelling | doaj-art-3f9a60928cee424dbfe2c7596ae9edc32025-02-03T06:08:17ZengWileyNursing Research and Practice2090-14292090-14372014-01-01201410.1155/2014/232046232046Cost-Effectiveness of Improving Health Care to People with HIV in NicaraguaEdward Broughton0Danilo Nunez1Indira Moreno2USAID Health Care Improvement Project, University Research Co., LLC, Bethesda 20814, USAUSAID Health Care Improvement Project, University Research Co., Managua, NicaraguaUSAID Health Care Improvement Project, University Research Co., Managua, NicaraguaBackground. A 2010 evaluation found generally poor outcomes among HIV patients on antiretroviral therapy in Nicaragua. We evaluated an intervention to improve HIV nursing services in hospital outpatient departments to improve patient treatment and retention in care. The intervention included improving patient tracking, extending clinic hours, caring for children of HIV+ mothers, ensuring medication availability, promoting self-help groups and family involvement, and coordinating multidisciplinary care. Methods. This pre/postintervention study examined opportunistic infections and clinical status of HIV patients before and after implementation of changes to the system of nursing care. Hospital expenditure data were collected by auditors and hospital teams tracked intervention expenses. Decision tree analysis determined incremental cost-effectiveness from the implementers’ perspective. Results. Opportunistic infections decreased by 24% (95% CI: 14%–34%) and 11.3% of patients improved in CDC clinical stage. Average per-patient costs decreased by $133/patient/year (95% CI: $29–$249). The intervention, compared to business-as-usual strategy, saved money while improving outcomes. Conclusions. Improved efficiency of services can allow more ART-eligible patients to receive therapy. We recommended the intervention be implemented in all HIV service facilities in Nicaragua.http://dx.doi.org/10.1155/2014/232046 |
| spellingShingle | Edward Broughton Danilo Nunez Indira Moreno Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua Nursing Research and Practice |
| title | Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua |
| title_full | Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua |
| title_fullStr | Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua |
| title_full_unstemmed | Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua |
| title_short | Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua |
| title_sort | cost effectiveness of improving health care to people with hiv in nicaragua |
| url | http://dx.doi.org/10.1155/2014/232046 |
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