UNAIDS Secretariat, Geneva, Switzerland.
Curr Opin HIV AIDS. 2010 May;5(3):215-24. doi: 10.1097/COH.0b013e32833860e9.
Increasing number of people living with HIV (PLHIV) will require expanded access to health services. Countries need robust and contemporary strategic information on the cost of care to monitor and evaluate the effectiveness, efficiency, equity, and acceptability of services. Published HIV cost literature from July 1999 to December 2008 was reviewed. Articles were identified using specific databases and scored, based on explicit criteria relating to the services covered, utilization data, cost data used and quality of the study.
One hundred and fifteen articles were identified, 47% came from North America, 29% from Europe, 17% from Africa and 8% from Asia; no studies from Latin America could be identified. The mean score across all studies was 33.7 out of a maximum of 64, with a median of 34 and a range of 11-51. Mean score did not change significantly over time (Pearson's R8 = 0.3; P > 0.05).
Great variation was observed in the methods used to estimate cost data across the studies identified, including range of services, patients covered and outcomes costed. Progress in the quantity and quality of studies published since 1999 has been limited. More consistent costing methods and more comprehensive coverage - both by country and level of care - are needed in order for policymakers and other stakeholders to be able to optimally monitor and evaluate the cost and cost-effectiveness of country services for HIV treatment and care, especially as population costs are likely to increase with more PLHIV on antiretroviral therapy.
随着感染艾滋病毒人数的增加，需要扩大获得医疗服务的机会。各国需要具备强大和现代的战略信息，以了解护理成本，从而监测和评估服务的有效性、效率、公平性和可接受性。本文对 1999 年 7 月至 2008 年 12 月发表的艾滋病毒成本文献进行了回顾。使用特定的数据库确定文章，并根据与所涵盖的服务、利用数据、使用的成本数据以及研究质量相关的明确标准对其进行评分。
共确定了 115 篇文章，其中 47%来自北美，29%来自欧洲，17%来自非洲，8%来自亚洲；没有发现来自拉丁美洲的研究。所有研究的平均得分为 64 分中的 33.7 分，中位数为 34 分，范围为 11-51 分。得分随时间的变化不明显（Pearson R8 = 0.3；P > 0.05）。
在所确定的研究中，用于估计成本数据的方法存在很大差异，包括服务范围、涵盖的患者和计价的结果。自 1999 年以来，发表的研究在数量和质量方面的进展有限。为了使决策者和其他利益攸关方能够最佳地监测和评估国家艾滋病毒治疗和护理服务的成本和成本效益，特别是随着更多艾滋病毒感染者接受抗逆转录病毒治疗，人口成本可能会增加，因此需要更一致的成本计算方法和更全面的覆盖范围——包括国家和护理水平。
