Comparison of HIV-infected patients' characteristics, healthcare resources use and cost between native and migrant patients.
OBJECTIVE
To assess whether patients' characteristics and healthcare resources consumption and costs were different between native and migrant populations in Switzerland.


METHODS
All adult patients followed-up in the Swiss HIV-cohort study in our institution during 2000-2003 were considered. Patients' characteristics were retrieved from the cohort database. Hospital and outpatient resource use were extracted from individual charts and valued with 2002 tariffs.


RESULTS
The 66 migrants were younger (29 +/- 8 years versus 37 +/- 11, p < 0.001), less often of male gender (38 % versus 70 %, p < 0.001), predominantly infected via heterosexual contact (87 % versus 52 %, p < 0.01), with lower mean CD4 level at enrollment (326 +/- 235 versus 437 +/- 305, p = 0.002) than their 200 native counterparts. Migrants had fewer hospitalizations, more frequent outpatient visits, laboratory tests, and lower total cost of care per year of follow-up (<euro> 2'215 +/- 4'206 versus 4'155 +/- 12'304, p = 0.037). Resource use and costs were significantly higher in people with < 200 CD4 cell counts in both groups.


CONCLUSIONS
Migrant population had more advanced disease, more outpatient visits but less hospitalizations, resulting in lower costs of care when compared with native population.
Wasserfallen
Jean-Blaise
JB
Institute of Health Economics and Management, University Hospital Center and University of Lausanne, Lausanne, Switzerland. jbw@chuv.ch
Hyjazi
Alexandre
A
Cavassini
Matthias
M
D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology* / Q000635:transmission; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data*; D013557:Switzerland; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult