Perelman Julian, Alves Joana, Miranda Ana Cláudia, Mateus Céu, Mansinho Kamal, Antunes Francisco, Oliveira Joaquim, Poças José, Doroana Manuela, Marques Rui, Teófilo Eugénio, Pereira João
Rev Saude Publica. 2013 Oct;47(5):865-72. doi: 10.1590/s0034-8910.2013047004598.
To analyze the direct medical costs of HIV/AIDS in Portugal from the perspective of the National Health Service.
A retrospective analysis of medical records was conducted for 150 patients from five specialized centers in Portugal in 2008. Data on utilization of medical resources during 12 months and patients' characteristics were collected. A unit cost was applied to each care component using official sources and accounting data from National Health Service hospitals.
The average cost of treatment was 14,277 €/patient/year. The main cost-driver was antiretroviral treatment (€ 9,598), followed by hospitalization costs (€ 1,323). Treatment costs increased with the severity of disease from € 11,901 (> 500 CD4 cells/µl) to € 23,351 (CD4 count ≤ 50 cells/ µl). Cost progression was mainly due to the increase in hospitalization costs, while antiretroviral treatment costs remained stable over disease stages.
The high burden related to antiretroviral treatment is counterbalanced by relatively low hospitalization costs, which, however, increase with severity of disease. The relatively modest progression of total costs highlights that alternative public health strategies that do not affect transmission of disease may only have a limited impact on expenditure, since treatment costs are largely dominated by constant antiretroviral treatment costs.
从国家卫生服务的角度分析葡萄牙艾滋病毒/艾滋病的直接医疗费用。
对2008年来自葡萄牙五个专科中心的150名患者的病历进行回顾性分析。收集了12个月内医疗资源利用情况的数据以及患者特征。使用官方来源和国家卫生服务医院的会计数据为每个护理项目应用单位成本。
治疗的平均费用为14,277欧元/患者/年。主要成本驱动因素是抗逆转录病毒治疗（9,598欧元），其次是住院费用（1,323欧元）。治疗费用随着疾病严重程度的增加而增加，从11,901欧元（>500个CD4细胞/微升）增至23,351欧元（CD4细胞计数≤50个/微升）。成本的增加主要是由于住院费用的增加，而抗逆转录病毒治疗费用在疾病各阶段保持稳定。
抗逆转录病毒治疗相关的高负担被相对较低的住院费用所抵消，然而住院费用会随着疾病严重程度的增加而增加。总成本的相对适度增长突出表明，不影响疾病传播的替代性公共卫生策略可能只会对支出产生有限影响，因为治疗费用在很大程度上由持续的抗逆转录病毒治疗费用主导。
