title: Comparison of healthcare costs between local and immigrant HIV populations living in Southern Alberta, Canada.
abstract: OBJECTIVE
  To compare the direct cost of care for Canadian and non-Canadian born HIV patients accessing initial HIV care.
  
  
  METHODS
  Drug, inpatient, and outpatient costs were collected for patients initiating HIV care at the Southern Alberta Clinic between 1/1/2000 and 3/31/2008 and followed until 3/31/2009. Demographic/clinical characteristics were obtained at initial visit. Country of birth determined Canadian (CBP) vs. foreign born (FBP) patients. Costs are mean cost per patient per month (PPPM) in 2009 Cdn$.
  
  
  RESULTS
  Of 281 patients, 103 were FBP. 86% were born in sub-Saharan Africa. FBP were more likely to be female (87% vs. 50%), younger (median 33 vs. 38 years), and heterosexual (93 vs. 35%)(all p<.01) compared to CBP. 74% FBP had CD4<350/mm(3) at initial visit compared to 61% of CBP (p<.05). Subsequent health outcomes for FBP/CBP were similar. Total mean costs PPPM were higher for CBP ($1174 vs. $1067, p<.05), and higher for all CD4 categories primarily due to the costs of non-HIV admissions among CBP injecting drug users (IDU), a risk group not represented within the FBP population of this study. Drugs costs were higher for FBP but lower for inpatient and outpatient costs.
  
  
  CONCLUSIONS
  Once engaged in regular HIV treatment and care, costs and outcomes for FBP were not significantly higher than CBP. Policy decisions concerning FBP with HIV should not be based solely on cost issues.
authors: Southern Alberta Clinic, Sheldon M Chumir Health Centre, #3223, 1213-4th St SW, Calgary AB T2R 0X7, Canada. hartmut.krentz@albertahealthservices.ca
authors: Hartmut B
authors: HB
authors: Krentz
authors: M John
authors: MJ
authors: Gill
mesh_terms: D000328:Adult; D000416:Alberta; D016527:Drug Costs / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged