Neuropsychiatric disorders in HIV infection : impact of diagnosis on economic costs of care
BACKGROUND: HAART is associated with a growing prevalence of HIV-associated neuropsychiatric disorders (NPD) despite improved overall survival.
OBJECTIVE: To investigate the added direct costs of medical care for patients with and without NPD.
METHODS: Nine dimensions of patient-specific costs [as costs per patient per month (CPM)] were followed prospectively between 1997 and 2003 in a community-based HIV/AIDS clinic for HIV-1-seropositive patients with a diagnosis of NPD (n = 188) and without (n = 153). Patients with NPD were stratified into subgroups of cognitive impairment (CI), peripheral neuropathies (PN), or other neuropsychiatric disorders (OND).
RESULTS: Compared with the non-NPD group ($916), patients in the NPD group showed an increased mean CPM during the 12-month intervals immediately preceding and subsequently following NPD diagnosis [$1371 (P < 0.001) and 1463 US dollars (P < 0.001), respectively], but not at 18 months prior to diagnosis (1061 US dollars; P > 0.05). Intragroup comparisons between 12 month post-diagnosis and 18 month pre-diagnosis showed a mean CPM increased of 67% (1613 US dollars; P < 0.001) with CI, 31% (1490 US dollars; P < 0.01) with PN, and 33% (1362 US dollars; P < 0.01) with OND. Increased numbers of clinic and physician visits, non-antiretroviral drugs and home care accounted for the higher mean CPM (P < 0.05) both pre-and post-diagnosis within the NPD group.
CONCLUSIONS: Neuropsychiatric disorders in patients with HIV/AIDS increase medical costs both before and after diagnosis, primarily owing to the management of the neuropsychiatric illness. Cost analyses offer useful measures of evolving patient needs, and provide a basis for allocation of healthcare resources.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2006 |
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| Erschienen: |
2006 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
AIDS (London, England) - 20(2006), 16 vom: 24. Okt., Seite 2005-9 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yeung, Helen [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 19.01.2007 Date Revised 20.10.2006 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM166102121 |
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| 100 | 1 | |a Yeung, Helen |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Neuropsychiatric disorders in HIV infection |b impact of diagnosis on economic costs of care |
| 264 | 1 | |c 2006 | |
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| 500 | |a Date Completed 19.01.2007 | ||
| 500 | |a Date Revised 20.10.2006 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: HAART is associated with a growing prevalence of HIV-associated neuropsychiatric disorders (NPD) despite improved overall survival | ||
| 520 | |a OBJECTIVE: To investigate the added direct costs of medical care for patients with and without NPD | ||
| 520 | |a METHODS: Nine dimensions of patient-specific costs [as costs per patient per month (CPM)] were followed prospectively between 1997 and 2003 in a community-based HIV/AIDS clinic for HIV-1-seropositive patients with a diagnosis of NPD (n = 188) and without (n = 153). Patients with NPD were stratified into subgroups of cognitive impairment (CI), peripheral neuropathies (PN), or other neuropsychiatric disorders (OND) | ||
| 520 | |a RESULTS: Compared with the non-NPD group ($916), patients in the NPD group showed an increased mean CPM during the 12-month intervals immediately preceding and subsequently following NPD diagnosis [$1371 (P < 0.001) and 1463 US dollars (P < 0.001), respectively], but not at 18 months prior to diagnosis (1061 US dollars; P > 0.05). Intragroup comparisons between 12 month post-diagnosis and 18 month pre-diagnosis showed a mean CPM increased of 67% (1613 US dollars; P < 0.001) with CI, 31% (1490 US dollars; P < 0.01) with PN, and 33% (1362 US dollars; P < 0.01) with OND. Increased numbers of clinic and physician visits, non-antiretroviral drugs and home care accounted for the higher mean CPM (P < 0.05) both pre-and post-diagnosis within the NPD group | ||
| 520 | |a CONCLUSIONS: Neuropsychiatric disorders in patients with HIV/AIDS increase medical costs both before and after diagnosis, primarily owing to the management of the neuropsychiatric illness. Cost analyses offer useful measures of evolving patient needs, and provide a basis for allocation of healthcare resources | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Krentz, Hartmut B |e verfasserin |4 aut | |
| 700 | 1 | |a Gill, M John |e verfasserin |4 aut | |
| 700 | 1 | |a Power, Christopher |e verfasserin |4 aut | |
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