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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e31827e8785
Brief Report: Clinical Science

Rates and Cost of Hospitalization Before and After Initiation of Antiretroviral Therapy in Urban and Rural Settings in South Africa

Meyer-Rath, Gesine MD*,†; Brennan, Alana T. MPH*,†; Fox, Matthew P. DSc*,†,‡; Modisenyane, Tebogo BSc§; Tshabangu, Nkeko RN§; Mohapi, Lerato MD§; Rosen, Sydney MPA*,†; Martinson, Neil MD, MPH§,‖

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Abstract

Abstract: Few studies have compared hospitalizations before and after antiretroviral therapy (ART) initiation in the same patients. We analyzed the cost of hospitalizations among 3906 adult patients in 2 South African hospitals, 30% of whom initiated ART. Hospitalizations were 50% and 40% more frequent and 1.5 and 2.6 times more costly at a CD4 cell count <100 cells/mm3 when compared with 200–350 cells/mm3 in the pre-ART and ART period, respectively. Mean inpatient cost per patient year was USD 117 (95% confidence interval, 85 to 158) for patients on ART and USD 72 (95% confidence interval, 56 to 89) for pre-ART patients. Raising ART eligibility thresholds could avoid the high cost of hospitalization before and immediately after ART initiation.

© 2013 Lippincott Williams & Wilkins, Inc.

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