Ontology highlight
ABSTRACT: Objective
Sub-Saharan Africa faces twin epidemics of HIV and noncommunicable diseases including hypertension. Integrating hypertension care into chronic HIV care is a global priority, but cost estimates are lacking. In the SEARCH Study, we performed population-level HIV/hypertension testing, and offered integrated streamlined chronic care. Here, we estimate costs for integrated hypertension/HIV care for HIV-positive individuals, and costs for hypertension care for HIV-negative individuals in the same clinics.Design
Microcosting analysis of healthcare expenditures within Ugandan HIV clinics.Methods
SEARCH (NCT: 01864603) conducted community health campaigns for diagnosis and linkage to care for both HIV and hypertension. HIV-positive patients received hypertension/HIV care jointly including blood pressure monitoring and medications; HIV-negative patients received hypertension care at the same clinics. Within 10 Ugandan study communities during 2015-2016, we estimated incremental annual per-patient hypertension care costs using micro-costing techniques, time-and-motion personnel studies, and administrative/clinical records review.Results
Overall, 70 HIV-positive and 2355 HIV-negative participants received hypertension care. For HIV-positive participants, average incremental cost of hypertension care was $6.29 per person per year, a 2.1% marginal increase over prior estimates for HIV care alone. For HIV-negative participants, hypertension care cost $11.39 per person per year, a 3.8% marginal increase over HIV care costs. Key costs for HIV-positive patients included hypertension medications ($6.19 per patient per year; 98% of total) and laboratory testing ($0.10 per patient per year; 2%). Key costs for HIV-negative patients included medications ($5.09 per patient per year; 45%) and clinic staff salaries ($3.66 per patient per year; 32%).Conclusion
For only 2-4% estimated additional costs, hypertension care was added to HIV care, and also expanded to all HIV-negative patients in prototypic Ugandan clinics, demonstrating substantial synergy. Our results should encourage accelerated scale-up of hypertension care into existing clinics.
SUBMITTER: Shade SB
PROVIDER: S-EPMC8030915 | biostudies-literature | 2021 May
REPOSITORIES: biostudies-literature
Shade Starley B SB Osmand Thomas T Kwarisiima Dalsone D Brown Lillian B LB Luo Alex A Mwebaza Betty B Mwesigye Aine Ronald AR Kwizera Enos E Imukeka Haawa H Mwanga Florence F Ayieko James J Owaraganise Asiphas A Bukusi Elizabeth A EA Cohen Craig R CR Charlebois Edwin D ED Black Douglas D Clark Tamara D TD Petersen Maya L ML Kamya Moses R MR Havlir Diane V DV Jain Vivek V
AIDS (London, England) 20210501 6
<h4>Objective</h4>Sub-Saharan Africa faces twin epidemics of HIV and noncommunicable diseases including hypertension. Integrating hypertension care into chronic HIV care is a global priority, but cost estimates are lacking. In the SEARCH Study, we performed population-level HIV/hypertension testing, and offered integrated streamlined chronic care. Here, we estimate costs for integrated hypertension/HIV care for HIV-positive individuals, and costs for hypertension care for HIV-negative individual ...[more]