Expenditures for the care of HIV-infected patients in rural areas in China's antiretroviral therapy programs

Zhou, Feng; Kominski, Gerald F.; Qian, Han-Zhu; Wang, Jiansheng; Duan, Song; Zhao, Xinping

doi:10.1186/1741-7015-9-6

Cited by 16 publications

(9 citation statements)

References 26 publications

(25 reference statements)

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“…This study also showed that for those living with HIV, the cost of laboratory tests accounted for the largest portion (37.46%) of associated in-patient costs, as those living with HIV may require semi-regular biochemical tests in order to track their disease progression while infected. Additional changes to current insurance policies, which promote reimbursement for laboratory tests could help lower patients' financial burden and promote compliance [15].…”

Section: Discussionmentioning

confidence: 99%

Analysis of hospitalization expenses of 610 HIV/AIDS patients in Nantong, China

Zhuang

Chen

Wu³

et al. 2020

BMC Health Serv Res

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Background: The goal of this study was to describe the expenses related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) management and care in Nantong Infectious Disease Hospital from October 2013 through June 2017. Methods: The information of 610 HIV/AIDS inpatients were collected from the Electronic Medical Record System of the hospital. Univariate and path analysis were employed to evaluate the association between hospitalization expense and its related factors. Results: The average hospitalization expenses per person was 5454 RMB (Renminbi, the currency of China, about $808 USD) and 23,555 RMB (about $3489 USD), respectively for HIV/AIDS patients. The average length of hospital stay was 10.0 ± 5.5 days for HIV patients and 21.7 ± 12.4 days for AIDS patients. For HIV patients, laboratory test fees constituted 37.46% of total expenses; while drug fees accounted for the largest proportion for AIDS patients. Path analysis indicated that the length of hospital stay was the most important factor affecting total expenses (total path coefficient = 0.563 for HIV patients and 0.649 for AIDS patients). Total expenses for HIV-infected females was higher than that of males (total path coefficient = 0.217), and the more complications led to higher expenses for AIDS patients. Conclusions: Though antiretroviral therapy (ART) is provided for free in China, associated medical care, particularly hospitalizations and fees, continue to drive up the medical costs of patients living with HIV and AIDS. Understanding the factors influencing these costs are crucial for determining policies and strategies that can reduce the economic burden of HIV/AIDS patients in China.

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Section: Discussionmentioning

confidence: 99%

Analysis of hospitalization expenses of 610 HIV/AIDS patients in Nantong, China

Zhuang

Chen

Wu³

et al. 2020

BMC Health Serv Res

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“…In Thailand the mean cost to treat patients with TB/HIV was $1535 vs $6341 in Brazil 21. In China, TB was the most expensive opportunistic infection in PLHIV after Cytomegalovirus infection: $647 and $3189, respectively 22. In South Africa, the cost of hospitalised patients with TB/HIV was $3925.…”

Section: Discussionmentioning

confidence: 99%

Economic burden of HIV and TB/HIV coinfection in a middle-income country: a costing analysis alongside a pragmatic clinical trial in Brazil

et al. 2018

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“…To protect HIV households from catastrophic spending the most straightforward approach suggested by this study is to reduce major out of pocket expenses including transportation and hospitalization costs. Increasing early access to testing and ART would decrease hospitalization costs since here, most patients presented with very low CD4 levels and there is still a need to scale up ART coverage in the country [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People's Democratic Republic

et al. 2015

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BackgroundThe scaling up of antiviral treatment (ART) coverage in the past decade has increased access to care for numerous people living with HIV/AIDS (PLWHA) in low-resource settings. Out-of-pocket payments (OOPs) represent a barrier for healthcare access, adherence and ART effectiveness, and can be economically catastrophic for PLWHA and their family. We evaluated OOPs of PLWHA attending outpatient and inpatient care units and estimated the financial burden for their households in the Lao People's Democratic Republic. We assumed that such OOPs may result in catastrophic health expenses in this context with fragile economical balance and low health insurance coverage.MethodsWe conducted a cross-sectional survey of a randomized sample of routine outpatients and a prospective survey of consecutive new inpatients at two referral hospitals (Setthathirat in the capital city, Savannaket in the province). After obtaining informed consent, PLWHA were interviewed using a standardized 82-item questionnaire including information on socio-economic characteristics, disease history and coping strategies. All OOPs occurring during a routine visit or a hospital stay were recorded. Household capacity-to-pay (overall income minus essential expenses), direct and indirect OOPs, OOPs per outpatient visit and per inpatient stay as well as catastrophic spending (greater than or equal to 40% of the capacity-to-pay) were calculated. A multivariate analysis of factors associated with catastrophic spending was conducted.ResultsA total of 320 PLWHA [280 inpatients and 40 outpatients; 132 (41.2%) defined as poor, and 269 (84.1%) on ART] were enrolled. Monthly median household income, essential expenses and capacity-to-pay were US$147.0 (IQR: 86–242), $126 (IQR: 82–192) and $14 (IQR: 19–80), respectively. At the provincial hospital OOPs were higher during routine visits, but three fold lower during hospitalization than in the central hospital ($21.0 versus $18.5 and $110.8 versus $329.8 respectively (p<0.01). The most notable OOPs were related to transportation and to loss of income. A total of 150 patients (46.8%; 95%CI: 41.3–52.5) were affected by catastrophic health expenses; 36 outpatients (90.0%; 95%CI: 76.3–97.2) and 114 inpatients (40.7%; 95%CI: 34.9–46.7). A total of 141 (44.0%) patients had contracted loans, and 127 (39.6%) had to sell some of their assets. In the multivariate analysis, being of Lao Loum ethnic group (Coef.-1.4; p = 0.04); being poor (Coef. -1.0; p = 0.01) and living more than 100 km away from the hospital (Coef.-1.0; p = 0.002) were positively associated with catastrophic spending. Conversely being in the highest wealth quartile (Coef. 1.6; p<0.001), living alone (Coef. 1.1; p = 0.04), attending the provincial hospital (Coef. 1.0; p = 0.002), and being on ART (Coef.1.2; p = 0.003), were negatively associated with catastrophic spending.ConclusionPLWHA’s households face catastrophic OOPs that are not directly attributable to the cost of ART or to follow-up tests, particularly during a hospitalization period. Transpo...

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Expenditures for the care of HIV-infected patients in rural areas in China's antiretroviral therapy programs

Cited by 16 publications

References 26 publications

Analysis of hospitalization expenses of 610 HIV/AIDS patients in Nantong, China

Analysis of hospitalization expenses of 610 HIV/AIDS patients in Nantong, China

Economic burden of HIV and TB/HIV coinfection in a middle-income country: a costing analysis alongside a pragmatic clinical trial in Brazil

Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People's Democratic Republic

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