Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment
Date
2022-07-01
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ
Abstract
Hepatitis B and HIV care share health
system challenges in the implementation of primary
prevention, screening, early linkage to care, monitoring
of therapeutic success and long-term medication
adherence.
Setting was Arua regional referral hospital (RRH) and Koboko
district hospital (DH), the West Nile region of Uganda.
The research design used was a cross-sectional hospital-based cost
minimisation study from the providers’ perspective
considers financial costs to measure the amount of money
spent on resources used in the stand-alone and integrated
pathways.
Data sources were clinic inputs and procurement invoices,
budgetary documents, open market information and expert
opinion. Data were extracted from 3121 files of HIV and
hepatitis B virus (HBV) monoinfected patients from the two
study sites.
The objective was to estimate provider costs associated with
running an integrated HBV and HIV clinical pathway for
patients on lifelong treatment in low-resource setting in
Uganda.
The outcome measures were the annual cost per patient was
simulated based on the total amount of resources spent
for all the expected number of patient visits to the facility
for HBV or HIV care per year.
Findings showed that Arua hospital had a
higher cost per patient in both clinics than did Koboko
Hospital. The cost per HBV patient was US$163.59
in Arua and US$145.76 in Koboko while the cost per
HIV patient was US$176.52 in Arua and US$173.23 in
Koboko. The integration resulted in a total saving of
US$36.73 per patient per year in Arua RRH and US$17.5
in Koboko DH.
In conclusion, the application of the integrated Pathway in
HIV and HBV patient management could improve hospital
cost efficiency compared with operating stand-alone
clinics.
Description
Keywords
Hepatitis B and HIV care, Health system challenges, Arua regional referral hospital (RRH), HIV and hepatitis B treatment, Koboko district hospital (DH),, West Nile region of Uganda