Cost of Hepatitis C care facilitation for HIV/Hepatitis C Co-infected people who use drugs.

Autor: Gutkind S; Department of Population Health Sciences, Weill Cornell Medical College, 425 E 61st St, New York, NY 10065, USA. Electronic address: sg3787@cumc.columbia.edu., Starbird LE; Columbia University School of Nursing, 560 West 168th St, New York, NY 10032, USA. Electronic address: starbird@nursing.upenn.edu., Murphy SM; Department of Population Health Sciences, Weill Cornell Medical College, 425 E 61st St, New York, NY 10065, USA. Electronic address: smm2010@med.cornell.edu., Teixeira PA; Department of Population Health Sciences, Weill Cornell Medical College, 425 E 61st St, New York, NY 10065, USA. Electronic address: pault212@gmail.com., Gooden LK; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA. Electronic address: lkg2129@columbia.edu., Matheson T; San Francisco Department of Health, 101 Grove St, San Francisco, CA 94102, USA. Electronic address: tim.matheson@sfdph.org., Feaster DJ; Department of Epidemiology and Public Health, University of Miami School of Medicine, 1120 NW 14th St Miami, FL 33136, USA. Electronic address: DFeaster@biostat.med.miami.edu., Jain MK; Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. Electronic address: Mamta.Jain@UTSouthwestern.edu., Masson CL; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA. Electronic address: Carmen.Masson@ucsf.edu., Perlman DC; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA. Electronic address: David.Perlman@mountsinai.org., Del Rio C; Department of Global Health, Rollins School of Public Health at Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA. Electronic address: cdelrio@emory.edu., Metsch LR; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA. Electronic address: lm2892@columbia.edu., Schackman BR; Department of Population Health Sciences, Weill Cornell Medical College, 425 E 61st St, New York, NY 10065, USA. Electronic address: brs2006@med.cornell.edu.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2022 Mar 01; Vol. 232, pp. 109265. Date of Electronic Publication: 2022 Jan 10.
DOI: 10.1016/j.drugalcdep.2022.109265
Abstrakt: Background: Using data from a randomized trial, we evaluated the cost of HCV care facilitation that supports moving along the continuum of care for HIV/HCV co-infected individuals with substance use disorder.
Methods: Participants were HIV patients residing in the community, initially recruited from eight US hospital sites. They received HCV care facilitation (n = 51) or treatment as usual (n = 62) for up to six months. We used micro-costing methods to evaluate costs from the healthcare sector and patient perspectives in 2017 USD. We conducted sensitivity analyses varying care facilitator caseloads and examined offsetting savings using participant self-reported healthcare utilization.
Results: The average site start-up cost was $6320 (site range: $4320-$7000), primarily consisting of training. The mean weekly cost per participant was $20 (site range: $4-$30) for care facilitation visits and contacts, $360 (site range: $130- $700) for supervision and client outreach, and $70 (site range: $20-$180) for overhead. In sensitivity analyses applying a weekly caseload of 10 participants per care facilitator (versus 1-6 observed in the trial), the total mean weekly care facilitation cost from the healthcare sector perspective decreased to $110. Weekly participant time and travel costs averaged $7. There were no significant differences in other healthcare service costs between participants in the intervention and control arms.
Conclusion: Weekly HCV care facilitation costs were approximately $450 per participant, but approximately $110 at a real-world setting maximum caseload of 10 participants per week. No healthcare cost offsets were identified during the trial period, although future savings might result from successful HCV treatment.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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