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Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya
OBJECTIVES: To estimate the modified societal costs of cervical cancer treatment in Kenya; and to compare the modified societal costs of treatment for pre-cancerous cervical lesions integrated into same-day HIV care compared to “non-integrated” treatment when the services are not coordinated on the...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553698/ https://www.ncbi.nlm.nih.gov/pubmed/31170193 http://dx.doi.org/10.1371/journal.pone.0217331 |
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author | Vodicka, Elisabeth L. Chung, Michael H. Zimmermann, Marita R. Kosgei, Rose J. Lee, Fan Mugo, Nelly R. Okech, Timothy C. Sakr, Samah R. Stergachis, Andy Garrison, Louis P. Babigumira, Joseph B. |
author_facet | Vodicka, Elisabeth L. Chung, Michael H. Zimmermann, Marita R. Kosgei, Rose J. Lee, Fan Mugo, Nelly R. Okech, Timothy C. Sakr, Samah R. Stergachis, Andy Garrison, Louis P. Babigumira, Joseph B. |
author_sort | Vodicka, Elisabeth L. |
collection | PubMed |
description | OBJECTIVES: To estimate the modified societal costs of cervical cancer treatment in Kenya; and to compare the modified societal costs of treatment for pre-cancerous cervical lesions integrated into same-day HIV care compared to “non-integrated” treatment when the services are not coordinated on the same day. MATERIALS AND METHODS: A micro-costing study was conducted at Coptic Hope Center for Infectious Diseases and Kenyatta National Hospital from July 1-October 31, 2014. Interviews were conducted with 54 patients and 23 staff. Direct medical, non-medical (e.g., overhead), and indirect (e.g., time) costs were calculated for colposcopy, cryotherapy, Loop Electrosurgical Excision Procedure (LEEP), and treatment of cancer. All costs are reported in 2017 US dollars. RESULTS: Patients had a mean age of 41 and daily earnings of $6; travel time to the facility averaged 2.8 hours. From the modified societal perspective, per-procedure costs of colposcopy were $41 (integrated) vs. $91 (non-integrated). Per-procedure costs of cryotherapy were $22 (integrated) vs. $46 (non-integrated), whereas costs of LEEP were $50 (integrated) and $99 (non-integrated). This represents cost savings of $25 for cryotherapy and $50 for colposcopy and LEEP when provided on the same day as an HIV-care visit. Treatment for cervical cancer cost $1,345-$6,514, depending on stage. Facility-based palliative care cost $59/day. CONCLUSIONS: Integrating treatment of pre-cancerous lesions into HIV care is estimated to be cost-saving from a modified societal perspective. These costs can be applied to financial and economic evaluations in Kenya and similar urban settings in other low-income countries. |
format | Online Article Text |
id | pubmed-6553698 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65536982019-06-17 Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya Vodicka, Elisabeth L. Chung, Michael H. Zimmermann, Marita R. Kosgei, Rose J. Lee, Fan Mugo, Nelly R. Okech, Timothy C. Sakr, Samah R. Stergachis, Andy Garrison, Louis P. Babigumira, Joseph B. PLoS One Research Article OBJECTIVES: To estimate the modified societal costs of cervical cancer treatment in Kenya; and to compare the modified societal costs of treatment for pre-cancerous cervical lesions integrated into same-day HIV care compared to “non-integrated” treatment when the services are not coordinated on the same day. MATERIALS AND METHODS: A micro-costing study was conducted at Coptic Hope Center for Infectious Diseases and Kenyatta National Hospital from July 1-October 31, 2014. Interviews were conducted with 54 patients and 23 staff. Direct medical, non-medical (e.g., overhead), and indirect (e.g., time) costs were calculated for colposcopy, cryotherapy, Loop Electrosurgical Excision Procedure (LEEP), and treatment of cancer. All costs are reported in 2017 US dollars. RESULTS: Patients had a mean age of 41 and daily earnings of $6; travel time to the facility averaged 2.8 hours. From the modified societal perspective, per-procedure costs of colposcopy were $41 (integrated) vs. $91 (non-integrated). Per-procedure costs of cryotherapy were $22 (integrated) vs. $46 (non-integrated), whereas costs of LEEP were $50 (integrated) and $99 (non-integrated). This represents cost savings of $25 for cryotherapy and $50 for colposcopy and LEEP when provided on the same day as an HIV-care visit. Treatment for cervical cancer cost $1,345-$6,514, depending on stage. Facility-based palliative care cost $59/day. CONCLUSIONS: Integrating treatment of pre-cancerous lesions into HIV care is estimated to be cost-saving from a modified societal perspective. These costs can be applied to financial and economic evaluations in Kenya and similar urban settings in other low-income countries. Public Library of Science 2019-06-06 /pmc/articles/PMC6553698/ /pubmed/31170193 http://dx.doi.org/10.1371/journal.pone.0217331 Text en © 2019 Vodicka et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Vodicka, Elisabeth L. Chung, Michael H. Zimmermann, Marita R. Kosgei, Rose J. Lee, Fan Mugo, Nelly R. Okech, Timothy C. Sakr, Samah R. Stergachis, Andy Garrison, Louis P. Babigumira, Joseph B. Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya |
title | Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya |
title_full | Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya |
title_fullStr | Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya |
title_full_unstemmed | Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya |
title_short | Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya |
title_sort | estimating the costs of hiv clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in kenya |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553698/ https://www.ncbi.nlm.nih.gov/pubmed/31170193 http://dx.doi.org/10.1371/journal.pone.0217331 |
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