Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment
Background Hepatitis B and HIV care share health system challenges in the implementation of primary prevention, screening, early linkage to care, monitoring of therapeutic success and long-term medication adherence.Setting Arua regional referral hospital (RRH) and Koboko district hospital (DH), the...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e058722.full |
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| author | Andrew Kambugu Philippa Easterbrook Jacinto Amandua David Livingstone Ejalu Joan N Mutyoba Claude Wandera Emmanuel Seremba Alex Muganzi Racheal Beyagira Kaggwa Mugagga Ponsiano Ocama |
| author_facet | Andrew Kambugu Philippa Easterbrook Jacinto Amandua David Livingstone Ejalu Joan N Mutyoba Claude Wandera Emmanuel Seremba Alex Muganzi Racheal Beyagira Kaggwa Mugagga Ponsiano Ocama |
| author_sort | Andrew Kambugu |
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| description | Background Hepatitis B and HIV care share health system challenges in the implementation of primary prevention, screening, early linkage to care, monitoring of therapeutic success and long-term medication adherence.Setting Arua regional referral hospital (RRH) and Koboko district hospital (DH), the West Nile region of Uganda.Design A cross-sectional hospital-based cost minimisation study from the providers’ perspective considers financial costs to measure the amount of money spent on resources used in the stand-alone and integrated pathways.Data sources Clinic inputs and procurement invoices, budgetary documents, open market information and expert opinion. Data were extracted from 3121 files of HIV and hepatitis B virus (HBV) monoinfected patients from the two study sites.Objective To estimate provider costs associated with running an integrated HBV and HIV clinical pathway for patients on lifelong treatment in low-resource setting in Uganda.Outcome measures The annual cost per patient was simulated based on the total amount of resources spent for all the expected number of patient visits to the facility for HBV or HIV care per year.Results Findings showed that Arua hospital had a higher cost per patient in both clinics than did Koboko Hospital. The cost per HBV patient was US$163.59 in Arua and US$145.76 in Koboko while the cost per HIV patient was US$176.52 in Arua and US$173.23 in Koboko. The integration resulted in a total saving of US$36.73 per patient per year in Arua RRH and US$17.5 in Koboko DH.Conclusion The application of the integrated Pathway in HIV and HBV patient management could improve hospital cost efficiency compared with operating stand-alone clinics. |
| format | Article |
| id | doaj-art-af1915c1557747419bc09281cfcf6f56 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-af1915c1557747419bc09281cfcf6f562025-01-31T06:25:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-058722Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessmentAndrew Kambugu0Philippa Easterbrook1Jacinto Amandua2David Livingstone Ejalu3Joan N Mutyoba4Claude Wandera5Emmanuel Seremba6Alex Muganzi7Racheal Beyagira8Kaggwa Mugagga9Ponsiano Ocama10Infectious Diseases Institute, Makerere University, Kampala, UgandaWorld Health Organization, Geneva, SwitzerlandMinistry of Health, Kampala, UgandaSchool of Public Health, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Biostatistics and Epidemiology, Makerere University College of Health Sciences, School of Public health, Kampala, UgandaInfectious Diseases Institute, Makerere University, Kampala, UgandaKiruddu National Referral Hospital, Kampala, UgandaInfectious Diseases Institute, Makerere University, Kampala, UgandaMinistry of Health, Kampala, UgandaWorld Health Organization, Country Office, Kampala, UgandaMakerere University College of Health Sciences, School of Medicine, Kampala, UgandaBackground Hepatitis B and HIV care share health system challenges in the implementation of primary prevention, screening, early linkage to care, monitoring of therapeutic success and long-term medication adherence.Setting Arua regional referral hospital (RRH) and Koboko district hospital (DH), the West Nile region of Uganda.Design A cross-sectional hospital-based cost minimisation study from the providers’ perspective considers financial costs to measure the amount of money spent on resources used in the stand-alone and integrated pathways.Data sources Clinic inputs and procurement invoices, budgetary documents, open market information and expert opinion. Data were extracted from 3121 files of HIV and hepatitis B virus (HBV) monoinfected patients from the two study sites.Objective To estimate provider costs associated with running an integrated HBV and HIV clinical pathway for patients on lifelong treatment in low-resource setting in Uganda.Outcome measures The annual cost per patient was simulated based on the total amount of resources spent for all the expected number of patient visits to the facility for HBV or HIV care per year.Results Findings showed that Arua hospital had a higher cost per patient in both clinics than did Koboko Hospital. The cost per HBV patient was US$163.59 in Arua and US$145.76 in Koboko while the cost per HIV patient was US$176.52 in Arua and US$173.23 in Koboko. The integration resulted in a total saving of US$36.73 per patient per year in Arua RRH and US$17.5 in Koboko DH.Conclusion The application of the integrated Pathway in HIV and HBV patient management could improve hospital cost efficiency compared with operating stand-alone clinics.https://bmjopen.bmj.com/content/12/7/e058722.full |
| spellingShingle | Andrew Kambugu Philippa Easterbrook Jacinto Amandua David Livingstone Ejalu Joan N Mutyoba Claude Wandera Emmanuel Seremba Alex Muganzi Racheal Beyagira Kaggwa Mugagga Ponsiano Ocama Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment BMJ Open |
| title | Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment |
| title_full | Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment |
| title_fullStr | Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment |
| title_full_unstemmed | Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment |
| title_short | Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment |
| title_sort | integrating hepatitis b care and treatment with existing hiv services is possible cost of integrated hiv and hepatitis b treatment in a low resource setting a cross sectional hospital based cost minimisation assessment |
| url | https://bmjopen.bmj.com/content/12/7/e058722.full |
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