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- Ghatnekar, Ola, et al.
(författare)
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Medical Resource Utilization and Cost of HIV-Related Care in the Highly Active Antiretroviral Therapy Era at a University Clinic in Sweden.
- 2010
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Ingår i: PharmacoEconomics. - : Springer Science and Business Media LLC. - 1179-2027 .- 1170-7690. ; 28:S1, s. 49-57
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Little is known regarding healthcare costs for HIV/AIDS patients in the era of highly active antiretroviral therapy (HAART) and subgroups of patients according to the severity and progression of HIV infection in Sweden. The objective of this study is therefore to describe the direct medical resource use and cost of healthcare for HIV patients at a university clinic in Sweden. Methods: A patient registry database for HIV treatment at the Department of Infectious Diseases, Sahlgrenska University Hospital, between 2000 and 2005 provided information on patient characteristics, antiretroviral drugs and dosages, tests and diagnostic procedures, outpatient visits and inpatient stays. The review used publicly available unit costs with a county council perspective, expressed in 2006 Euros. Results: Two hundred and eighty-five patients with a mean age of 38 years in 2000 (64% men) were followed for 1368 patient-years. They had a mean (median) of 6.3 (0) inpatient days, 4.1 (3.7) physician visits, 4.2 (3.8) nurse visits, 2.6 (0.7) counsellor visits and 11.5 (7.7) tests and diagnostic procedures per patient-year. Only 12 deaths were recorded during the study period, and the proportion of treated patients with successful treatment (HIV-RNA <50copies/mL) increased from 74% to 92% during the period. The mean cost per patient-month amounted to &U20AC;1069. The main cost driver was HIV drugs (51%), followed by inpatient stays (including hospitalizations for opportunistic infections; 22%), outpatient physician, nurse or therapist visits (19%) and diagnostics and tests (7%). All non-drug costs increased with a decreasing CD4 cell count. Conclusions: Overall, approximately half of the direct costs of HIV treatment were not related to antiretroviral treatment. The non-antiretroviral costs were inversely correlated with HIV-induced immune deficiency.
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| 2. |
- Hjortsberg, Catharina, et al.
(författare)
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The Value of Informal Caregiver Time for Psychotic Illness
- 2010
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Ingår i: Journal of Mental Health Policy and Economics. - 1099-176X. ; 13:3, s. 127-133
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychotic illness can have a substantial economic burden not only on the patient and society in general, but also on family members providing informal care (i.e. those not subject to a market wage). While informal caregiving confers benefits for the patient and society, time spent providing informal care is diverted from other activities such as work or leisure. Relatives and caregivers experience burden both on a practical and an emotional level. Informal caregiving has often gone unrecognised in public policy discussions about the financing and costs of health care. Aim: The aim of this paper is to provide suggestions for valuing caregiver time for psychotic illness. Materials and Methods Literature on the costs of informal care and the cost of leisure time, is used to discuss possibilities for estimating the value of informal care. Results: The monetary value of informal care depends on income levels both for those who give up paid work and for those who forego leisure time. Estimates are thus context dependent and might be difficult to generalise. Discussion: Informal care is a substantial part of total patient care, especially for chronic illness. The support of family caregivers for patients with mental illnesses often has an important impact on the general well-being of the patient. Because it is typically unpaid, informal care has been seen as a low cost, even costless, substitute for formal care. Placing a value on the hours of care provided by informal caregivers for patients suffering from mental illnesses is necessary if one wants to provide an accurate picture of the costs associated with the diseases. Time spent on informal care has a value and methods of estimating costs of informal care are available. Implications for Health Care Provision and Use: Cost studies should take account of the cost of informal care, as ignoring informal care means that it is viewed as a costless substitute for formal care. While informal care is unpaid, it is not free in an economic sense since time spent providing care cannot be directed to other activities such as paid work or leisure. From a societal perspective, not accounting for informal care may lead to a poor allocation of resources and a disregard of the effect of informal care on the health and well-being of caregivers. Cost of informal care constitutes a sizeable proportion of total costs and should not be neglected.
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