Healthcare utilization of patients accessing an African national treatment program

Simple item page
dc.contributor.authorHarling, Guyen_ZA
dc.contributor.authorOrrell, Catherineen_ZA
dc.contributor.authorWood, Robinen_ZA
dc.date.accessioned2015-10-12T10:51:38Z
dc.date.available2015-10-12T10:51:38Z
dc.date.issued2007en_ZA
dc.description.abstractBACKGROUND:The roll-out of antiretroviral therapy (ART) in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. METHODS: This paper describes healthcare utilization from program entry by treatment-naive patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count <200 cells/mul or an AIDS-defining illness. Data on health service utilization were collected retrospectively from the primary-care clinic and secondary and tertiary referral hospitals. Hospital visits were reviewed to determine the clinical reason for each visit. RESULTS: 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO), excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. CONCLUSION: Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.en_ZA
dc.identifier.apacitationHarling, G., Orrell, C., & Wood, R. (2007). Healthcare utilization of patients accessing an African national treatment program. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/14166en_ZA
dc.identifier.chicagocitationHarling, Guy, Catherine Orrell, and Robin Wood "Healthcare utilization of patients accessing an African national treatment program." <i>BMC Health Services Research</i> (2007) http://hdl.handle.net/11427/14166en_ZA
dc.identifier.citationHarling, G., Orrell, C., & Wood, R. (2007). Healthcare utilization of patients accessing an African national treatment program. BMC health services research, 7(1), 80.en_ZA
dc.identifier.ris TY - Journal Article AU - Harling, Guy AU - Orrell, Catherine AU - Wood, Robin AB - BACKGROUND:The roll-out of antiretroviral therapy (ART) in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. METHODS: This paper describes healthcare utilization from program entry by treatment-naive patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count <200 cells/mul or an AIDS-defining illness. Data on health service utilization were collected retrospectively from the primary-care clinic and secondary and tertiary referral hospitals. Hospital visits were reviewed to determine the clinical reason for each visit. RESULTS: 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO), excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. CONCLUSION: Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates. DA - 2007 DB - OpenUCT DO - 10.1186/1472-6963-7-80 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2007 T1 - Healthcare utilization of patients accessing an African national treatment program TI - Healthcare utilization of patients accessing an African national treatment program UR - http://hdl.handle.net/11427/14166 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14166
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-7-80
dc.identifier.vancouvercitationHarling G, Orrell C, Wood R. Healthcare utilization of patients accessing an African national treatment program. BMC Health Services Research. 2007; http://hdl.handle.net/11427/14166.en_ZA
dc.language.isoengen_ZA
dc.publisherBiomed Central Ltden_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://www.biomedcentral.com/bmchealthservres/en_ZA
dc.subject.otherHealth care utilizationen_ZA
dc.titleHealthcare utilization of patients accessing an African national treatment programen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Harling_Healthcare_utilization_treatment_program_2007.pdf
Size:
377.99 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles