engleski

The efficiency of introducing the EmERGE Pathway of care for stable Croatian PLHIV

Purpose: Estimate the cost-effectiveness of introducing a mHealth supported Pathway of Care for clinically stable people living with HIV in Zagreb. The EmERGE Pathway enables individuals to receive HIV treatment information on their smart-phone via the mHealth App. Method: 293 study participants predominantly used HIV outpatient services, the focus of the costing study. Unit costs were linked to mean per patient year (MPY) use of HIV services. Data on use of services were collected retrospectively one-year before and prospectively one-year after the introduction of the mHealth Pathway, enabling annual cost of HIV service provision to be estimated. Annual costs were combined with outcome data, changes in CD4 count and Viral Load one-year before and after the introduction of the mHealth Pathway. Costing were calculated in Croatian Kuna and converted to Euros. Results: Mean outpatient visits decreased from 5.2 (95% CI: 4.9 to 5.5) to 4.75 (95% CI: 4.5 to 5.0) MPY. The annual costs of service provision were €8, 885.30 (95% CI €8, 833.90 to €8, 938.60) pre-mHealth and €8, 716.20 (95% CI €8, 673.40 to €8, 761.40) post-mHealth ; clinic visits and tests comprised 10% of total costs, ARVs 55% and other pharmacy costs 35% of annual costs. No significant differences in CD4 counts were observed between periods and Viral Load remained undetectable during each period with no significant difference between pre-mHealth and post-mHealth values. Conclusion: Annual cost pre- and post- mHealth Pathway decreased by 2%. Cost for ARVs and Pharmacy services were the greatest cost drivers. Participants remained clinically stable after the introduction of mHealth Pathway of Care, which has been an efficient intervention. Future efficiencies can be anticipated with introduction of the Pathway across the clinical site. Additional analyses will include other outcomes such as quality of life (PROQOL-HIV), self-management (PAM13) and patient out-of-pocket expenditures.

EmERGE Pathway ; Care ; Croatian ; PLHIV

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