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Resource utilization and direct costs of pediatric HIV in Italy

机译：意大利儿童艾滋病毒的资源利用和直接成本

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This multicenter, prospective, observational study assessed the global economic impact of HIV care in a large cohort of HIV-infected children and adolescents in Italy. Three pediatric departments of reference participated on a voluntary basis. Centers were asked to enroll all their children during the period April 2010-March 2011. At enrollment, a pediatrician completed a questionnaire for each patient, including the type of service at access (outpatient consultation or day hospital), laboratory tests, instrumental examinations, specialists' consultations, antiretroviral therapy and opportunistic illness prophylaxis. Eligible patients had a confirmed diagnosis of HIV infection caused by direct vertical maternal-fetal transmission, their age ranging from 0 to 24 years. Since patients routinely have quarterly check-ups in all three centers, we adopted a three-month time horizon. Health-care services were priced using outpatient and inpatient tariffs. Drug costs were calculated by multiplying the daily dose by the public price for each active ingredient. A total of 142 patients were enrolled. More than half the patients were female and the mean age was 14 years, with no significant differences by center. There were substantial differences in health-care management among the three centers, particularly as regards the type of access. One center enrolled the majority of its patients in day-hospital and prescribed a large number of clinical tests, while children accessed another center almost exclusively through outpatient consultation. Drug therapy was the main cost component and was very similar in all three centers. The day-hospital was the second highest cost component, much higher than outpatient consultation (including examinations), leading to significant differences between total costs per center. These findings suggest that a recommendation to the Italian National Health Service would be to use more outpatient consultation for patients' access in order to increase their efficiency in treating pediatric HIV infection.
机译：这项多中心，前瞻性，观察性研究评估了意大利一大批受HIV感染的儿童和青少年对HIV护理的全球经济影响。三个儿科参考部门是自愿参加的。中心被要求在2010年4月至2011年3月期间为所有孩子入学。入学时，儿科医生为每位患者填写了一份调查表，包括就诊服务类型（门诊或日间医院），实验室检查，仪器检查，专家咨询，抗逆转录病毒疗法和机会性疾病预防。符合条件的患者已被确诊为由直接垂直母婴传播引起的HIV感染，其年龄为0至24岁。由于患者通常在所有三个中心进行季度检查，因此我们采用了三个月的时间范围。卫生保健服务按门诊和住院费用计价。药物成本是通过将每种活性成分的每日剂量乘以公共价格得出的。共有142位患者入组。一半以上的患者为女性，平均年龄为14岁，各中心之间无显着差异。三个中心之间在卫生保健管理方面存在重大差异，特别是在获取类型方面。一个中心将大部分患者纳入了日间医院，并进行了大量的临床检查，而孩子们几乎只能通过门诊咨询进入另一个中心。药物治疗是主要的费用组成部分，在所有三个中心都很相似。日间医院是第二高的费用组成部分，远高于门诊（包括检查）的费用，导致每个中心的总费用之间存在显着差异。这些发现表明，向意大利国家卫生局（National Health Service）的建议是增加患者的门诊服务，以提高他们治疗小儿HIV感染的效率。

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