title: Rates and cost of hospitalization before and after initiation of antiretroviral therapy in urban and rural settings in South Africa.
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/mm(3) when compared with 200–350 cells/mm(3) 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.
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA. gesine@bu.edu
authors.forename: Gesine
authors.initials: G
authors.lastname: Meyer-Rath
authors.forename: Alana T
authors.initials: AT
authors.lastname: Brennan
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Fox
authors.forename: Tebogo
authors.initials: T
authors.lastname: Modisenyane
authors.forename: Nkeko
authors.initials: N
authors.lastname: Tshabangu
authors.forename: Lerato
authors.initials: L
authors.lastname: Mohapi
authors.forename: Sydney
authors.initials: S
authors.lastname: Rosen
authors.forename: Neil
authors.initials: N
authors.lastname: Martinson
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data; D013019:South Africa; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D044966:Anti-Retroviral Agents