Decreased morbidity and use of hospital services in English HIV-infected individuals with increased uptake of anti-retroviral therapy 1996-1997

Beck, Eduard J.; Mandalia, Sundhiya; Williams, IG; Power, A. A.; Newson, Roger; Molesworth, Anna; Barlow, David H.; Easterbrook, Philippa; Fisher, Martin; Innes, John; Kinghorn, G R; Mandel, B; Pozniak, Anton; Tang, Alan; Tomlinson, David R.

doi:10.1097/00002030-199910220-00020

Cited by 41 publications

(29 citation statements)

References 18 publications

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“…[2][3][4][5][6][7][8][9][10] Highly active antiretroviral therapy (HAART) has revolutionized the treatment of HIV leading to significant declines in HIV related morbidity and mortality as well as declines in hospitalization. [11][12][13][14][15][16][17] Although previous studies suggest that individuals with SMI are less likely to receive potentially life saving interventions for non-HIV-related chronic conditions, [18;19] few studies have evaluated the degree to which HIV infected individuals with SMI receive HAART. One study using New Jersey Medicaid claims data from 1996-1998 found that patients with serious mental illness were more likely to have initiated new antiretroviral therapy, defined as receiving a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor, compared to those without serious mental illness.…”

Section: Introductionmentioning

confidence: 99%

Access to HAART and utilization of inpatient medical hospital services among HIV-infected patients with co-occurring serious mental illness and injection drug use

Himelhoch

Chander

Fleishman

et al. 2007

General Hospital Psychiatry

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Objective-Among HIV infected individuals we examined whether having a co-occurring serious mental illness (SMI) and injection drug use (IDU) impacts: (1) receipt of HAART and (2) utilization of inpatient HIV services, compared to those who have SMI only, IDU only, or neither.Methods-Demographic, clinical, and resource utilization data were collected from medical records of 5,119 patients in HIV primary care at 4 U.S. HIV care sites in different geographic regions with on-site mental health services in 2001. We analyzed receipt of HAART using multivariate logistic regression and number of medical hospital admissions using multivariate logistic and Poisson regression analyses, which controlled for demographic factors, receipt of HAART, CD4 count and HIV-1 RNA. Conclusions-HIV-infected individuals with co-occurring SMI and IDU are significantly more likely to utilize HIV-related medical inpatient services than individuals with no or only one comorbidity. Individuals with both SMI and IDU did not differ from those with IDU only in receipt of HAART. Inpatient hospitalizations are expensive, and efforts should be targeted towards these populations to reduce potentially avoidable inpatient care. Results-

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Section: Introductionmentioning

confidence: 99%

Access to HAART and utilization of inpatient medical hospital services among HIV-infected patients with co-occurring serious mental illness and injection drug use

Himelhoch

Chander

Fleishman

et al. 2007

General Hospital Psychiatry

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“…These cost figures convey strong policy implications to business decision making for employment strategies in developing countries.With the introduction of more effective antiretroviral therapies, a wide range of remarkable improvement has been observed in HIV/AIDS treatment outcomes, ranging from longer survival time and increased quality of life. In the meantime, the direct treatment costs have also changed substantially, resulting from the use of advanced antiretroviral therapies [33,34,35,36,37,38,39,40,41,42,43]. Therefore, following our modeling framework, further study will assess the incremental benefits and costs of advanced antiretroviral combination therapy in treating HIV-infected workers against the benchmark costs.…”

Section: Discussionmentioning

confidence: 99%

Economic costs of HIV infection: an employer's perspective

Liu

Yin

Lyu

et al. 2002

The European Journal of Health Economics

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The introduction of highly active antiretroviral therapy has proven highly effective in treating patients with HIV/AIDS. However, the high cost of the advanced antiretroviral therapy has led to increased financial constraints on both patients and payers. From business firms'perspective, especially those with operations in developing countries, it is crucial to determine the long-term economic cost implications of alternative employment and benefit policies for HIV-infected workers or those at high risk for the disease. A simulation model is developed to predict the comprehensive lifetime economic costs of HIV-infected workers to an employer. This model employs age,CD4(+) cell counts,and plasma HIV-1 RNA level as major predictors of the disease progression and patient survival in the determination of various cost functions. Major cost components considered include direct expenses on health insurance premium,life insurance premium, short-term disability benefits, long-term disability benefits, hiring/training expenses, and indirect costs resulting from reduced or lost productivity at work. An individual model and a group model are derived to estimate the costs of an individual and a group of HIV-infected patients, respectively. Over a 10-year period, following the nonadvanced antiretroviral treatment regimen, the group model predicts that the total lifetime cost of an HIV-infected worker can be as high as U.S. 90,000 dollars to his/her employer, of which 60,000 dollars would be various explicit costs and 30,000 dollars lost work productivity. Sensitivity analysis further demonstrated that changes in the initial level of age,CD4(+) cell count, HIV-1 RNA viral load,CD4(+) cell decline rate, and the costs of medical care influence the dynamics of the cost functions. HIV infection can result in sizable economic costs to an employer over the lifetime course of an infected employee if not treated with the advanced antiretroviral therapy. These cost estimates provide a rational economic basis for an employer to optimally assess the longrun costs and benefits of alternative employment and insurance policies in the care of employees with HIV infection.

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“…152 The National Prospective Monitoring survey has been used to assess intermediate outcomes such as viral load in HIV patients. 149 The UK Thalassaemia Register has been used to assess the outcomes of screening for affected couples. 162 Comparative audit was the most common role for clinical registers with around half being used for this purpose.…”

Section: Use In Ht Assessmentmentioning

confidence: 99%

Potential use of routine databases in health technology assessment

Raftery

Roderick²,

Stevens³

2005

Health Technol Assess

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Decreased morbidity and use of hospital services in English HIV-infected individuals with increased uptake of anti-retroviral therapy 1996-1997

Cited by 41 publications

References 18 publications

Access to HAART and utilization of inpatient medical hospital services among HIV-infected patients with co-occurring serious mental illness and injection drug use

Access to HAART and utilization of inpatient medical hospital services among HIV-infected patients with co-occurring serious mental illness and injection drug use

Economic costs of HIV infection: an employer's perspective

Potential use of routine databases in health technology assessment

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