艾滋病病毒检测与咨询以及预防母婴传播服务链上的成本。

Costs along the service cascades for HIV testing and counselling and prevention of mother-to-child transmission.

作者信息

Bautista-Arredondo Sergio, Sosa-Rubí Sandra G, Opuni Marjorie, Contreras-Loya David, Kwan Ada, Chaumont Claire, Chompolola Abson, Condo Jeanine, Galárraga Omar, Martinson Neil, Masiye Felix, Nsanzimana Sabin, Ochoa-Moreno Ivan, Wamai Richard, Wang'ombe Joseph

机构信息

aNational Institute of Public Health (INSP), Division of Health Economics, Cuernavaca, Mexico bUNAIDS, Geneva, Switzerland cDivision of Economics, University of Zambia, Lusaka, Zambia dNational University of Rwanda, School of Public Health, Kigali, Rwanda eBrown University, Providence, Rhode Island, USA fPerinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa gRwanda Biomedical Center, Kigali, Rwanda hNortheastern University, Boston, Massachusetts, USA iUniversity of Nairobi, School of Public Health, Nairobi, Kenya.

出版信息

AIDS. 2016 Oct 23;30(16):2495-2504. doi: 10.1097/QAD.0000000000001208.

DOI:10.1097/QAD.0000000000001208

PMID:27753679

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5051528/

Abstract

OBJECTIVE

We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades.

DESIGN

Data collected covered the period 2011-2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia.

METHODS

Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers' perspective using micro-costing. Average annual costs per client in 2013 United States dollars (US$) were estimated along the service cascades.

RESULTS

For HTC, average cost per client tested ranged from US$5 (SD US$7) in Rwanda to US$31 (SD US$24) in South Africa, whereas average cost per client diagnosed as HIV-positive ranged from US$122 (SD US$119) in Zambia to US$1367 (SD US$2093) in Rwanda. For PMTCT, average cost per client tested ranged from US$18 (SD US$20) in Rwanda to US$89 (SD US$56) in South Africa; average cost per client diagnosed as HIV-positive ranged from US$567 (SD US$417) in Zambia to US$2021 (SD US$3210) in Rwanda; average cost per client on antiretroviral prophylaxis ranged from US$704 (SD US$610) in South Africa to US$2314 (SD US$3204) in Rwanda; and average cost per infant on nevirapine ranged from US$888 (SD US$884) in South Africa to US$2359 (SD US$3257) in Rwanda.

CONCLUSION

We found important differences in unit costs along the HTC and PMTCT service cascades within and between countries suggesting that more efficient delivery of these services is possible.

摘要

目的

我们估算了在艾滋病病毒检测与咨询（HTC）以及预防母婴传播（PMTCT）服务流程中各机构层面每位服务对象的年均成本。

设计

收集的数据涵盖了2011年至2012年期间肯尼亚、卢旺达、南非和赞比亚的230个艾滋病病毒检测与咨询机构以及212个预防母婴传播机构的情况。

方法

收集了投入数量和单价以及产出数据。从服务提供者的角度采用微观成本核算方法估算年度经济成本。沿着服务流程估算了以2013年美元计算的每位服务对象的年均成本。

结果

对于艾滋病病毒检测与咨询服务，每位接受检测的服务对象的平均成本在卢旺达为5美元（标准差7美元），在南非为31美元（标准差24美元）；而每位被诊断为艾滋病病毒阳性的服务对象的平均成本在赞比亚为122美元（标准差119美元），在卢旺达为1367美元（标准差2093美元）。对于预防母婴传播服务，每位接受检测的服务对象的平均成本在卢旺达为18美元（标准差20美元），在南非为89美元（标准差56美元）；每位被诊断为艾滋病病毒阳性的服务对象的平均成本在赞比亚为567美元（标准差417美元），在卢旺达为2021美元（标准差3210美元）；每位接受抗逆转录病毒药物预防治疗的服务对象的平均成本在南非为704美元（标准差610美元），在卢旺达为2314美元（标准差3204美元）；每位使用奈韦拉平的婴儿的平均成本在南非为888美元（标准差884美元），在卢旺达为2359美元（标准差3257美元）。