title: Cost analyses of peer health worker and mHealth support interventions for improving AIDS care in Rakai, Uganda.
abstract: A cost analysis study calculates resources needed to deliver an intervention and can provide useful information on affordability for service providers and policy-makers. We conducted cost analyses of both a peer health worker (PHW) and a mHealth (mobile phone) support intervention. Excluding supervisory staffing costs, total yearly costs for the PHW intervention was $8475, resulting in a yearly cost per patient of $8.74, per virologic failure averted cost of $189, and per patient lost to follow-up averted cost of $1025. Including supervisory staffing costs increased total yearly costs to $14,991. Yearly costs of the mHealth intervention were an additional $1046, resulting in a yearly cost per patient of $2.35. In a threshold analysis, the PHW intervention was found to be cost saving if it was able to avert 1.50 patients per year from switching to second-line antiretroviral therapy. Other AIDS care programs may find these intervention costs affordable.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA. lchang8@jhmi.edu
authors.forename: Larry W
authors.initials: LW
authors.lastname: Chang
authors.forename: Joseph
authors.initials: J
authors.lastname: Kagaayi
authors.forename: Gertrude
authors.initials: G
authors.lastname: Nakigozi
authors.forename: David
authors.initials: D
authors.lastname: Serwada
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bollinger
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Reynolds
authors.forename: David
authors.initials: D
authors.lastname: Holtgrave
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000628:therapy*; D040421:Cell Phone / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000379:methods; D003365:Costs and Cost Analysis; D006801:Humans; D010348:Patient Care Team / Q000191:economics; D011787:Quality of Health Care / Q000191:economics; D012189:Retrospective Studies; D017216:Telemedicine / Q000191:economics*; D014454:Uganda