Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya.
<h4>Objectives</h4>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 service...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0217331 |
| _version_ | 1797660701779558400 |
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| author | Elisabeth L Vodicka Michael H Chung Marita R Zimmermann Rose J Kosgei Fan Lee Nelly R Mugo Timothy C Okech Samah R Sakr Andy Stergachis Louis P Garrison Joseph B Babigumira |
| author_facet | Elisabeth L Vodicka Michael H Chung Marita R Zimmermann Rose J Kosgei Fan Lee Nelly R Mugo Timothy C Okech Samah R Sakr Andy Stergachis Louis P Garrison Joseph B Babigumira |
| author_sort | Elisabeth L Vodicka |
| collection | DOAJ |
| description | <h4>Objectives</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| first_indexed | 2024-03-11T18:33:45Z |
| format | Article |
| id | doaj.art-3a6f28278bda438b9c6afcbc873bfc8d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-11T18:33:45Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-3a6f28278bda438b9c6afcbc873bfc8d2023-10-13T05:32:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01146e021733110.1371/journal.pone.0217331Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya.Elisabeth L VodickaMichael H ChungMarita R ZimmermannRose J KosgeiFan LeeNelly R MugoTimothy C OkechSamah R SakrAndy StergachisLouis P GarrisonJoseph B Babigumira<h4>Objectives</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0217331 |
| spellingShingle | Elisabeth L Vodicka Michael H Chung Marita R Zimmermann Rose J Kosgei Fan Lee Nelly R Mugo Timothy C Okech Samah R Sakr Andy Stergachis Louis P Garrison Joseph B Babigumira Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya. PLoS ONE |
| 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 |
| url | https://doi.org/10.1371/journal.pone.0217331 |
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