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The Efficiency of the EmERGE Platform for Medically Stable People Living with HIV in Portugal

dc.contributor.authorBeck, E
dc.contributor.authorMandalia, S
dc.contributor.authorYfantopoulos, P
dc.contributor.authorJones, C
dc.contributor.authorBremner, S
dc.contributor.authorWhetham, J
dc.contributor.authorCunha, AS
dc.contributor.authorTeofilo, E
dc.contributor.authorRodrigues, G
dc.contributor.authorBorges, M
dc.date.accessioned2023-05-24T14:08:16Z
dc.date.available2023-05-24T14:08:16Z
dc.date.issued2022
dc.description.abstractBackground: The aim of this study was to calculate the cost-effectiveness of the EmERGE Pathway of Care for medically stable people living with HIV in the Hospital Capuchos, Centro Hospitalar Universitário de Lisboa Central (HC-CHLC). The app enables individuals to receive HIV treatment information and communicate with caregivers. Methods: This before-and-after study collected the use of services data 1 year before implementation and after implementation of EmERGE from November 1, 2016, to October 30, 2019. Departmental unit costs were calculated and linked to mean use of outpatient services per patient-year (MPPY). Annual costs per patient-year were combined with primary (CD4 count; viral load) and secondary outcomes (PAM-13; PROQOL-HIV). Results: Five hundred eighty-six EmERGE participants used HIV outpatient services. Annual outpatient visits decreased by 35% from 3.1 MPPY (95% confidence interval [CI]: 3.0-3.3) to 2.0 (95% CI: 1.9-2.1) as did annual costs per patient-year from €301 (95% CI: €288-€316) to €193 (95% CI: €182-€204). Laboratory tests and costs increased by 2%, and radiology investigations decreased by 40% as did costs. Overall annual cost for HIV outpatient services decreased by 5% from €2093 (95% CI: €2071-€2112) to €1984 (95% CI: €1968-€2001); annual outpatient costs decreased from €12,069 (95% CI: €12,047-€12,088) to €11,960 (95% CI: €11,944-€11,977), with 83% of annual cost because of antiretroviral therapy (ART). Primary and secondary outcome measures did not differ substantially between periods. Conclusions: The EmERGE Pathway produced cost savings after implementation-extended to all people living with HIV additional savings are likely to be produced, which can be used to address other needs. Antiretroviral drugs (ARVs) were the main cost drivers and more expensive in Portugal compared with ARV costs in the other EmERGE sites.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPorto Biomed J . 2022 Oct 24;7(5):e191.pt_PT
dc.identifier.doi10.1097/j.pbj.0000000000000191pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4530
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWolters Kluwerpt_PT
dc.subjectHSAC MEDpt_PT
dc.subjectPLHIVpt_PT
dc.subjectPortugalpt_PT
dc.subjectCost of HIV Servicespt_PT
dc.subjectEfficiency EmERGEpt_PT
dc.subjectmHealthpt_PT
dc.titleThe Efficiency of the EmERGE Platform for Medically Stable People Living with HIV in Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue5pt_PT
oaire.citation.startPagee191pt_PT
oaire.citation.titlePorto Biomedical Journalpt_PT
oaire.citation.volume7pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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