Retention in Care and Outpatient Costs for Children Receiving Antiretroviral Therapy in Zambia: A Retrospective Cohort Analysis

Callie A Scott, Hari Iyer, Deophine Lembela Bwalya, Kelly McCoy, Gesine Meyer-Rath, Crispin Moyo, Carolyn Bolton-Moore, Bruce Larson and Sydney Rosen

PLOS ONE, 2013, vol. 8, issue 6, 1-8

Abstract: Background: There are few published estimates of the cost of pediatric antiretroviral therapy (ART) in Africa. Our objective was to estimate the outpatient cost of providing ART to children remaining in care at six public sector clinics in Zambia during the first three years after ART initiation, stratified by service delivery site and time on treatment. Methods: Data on resource utilization (drugs, diagnostics, outpatient visits, fixed costs) and treatment outcomes (in care, died, lost to follow up) were extracted from medical records for 1,334 children at six sites who initiated ART at 50%) at four sites. At the two remaining sites, outpatient visits and fixed costs together accounted for >50% of outpatient costs. The distribution of costs is slightly skewed, with median costs 3% to 13% lower than average costs during the first year after ART initiation depending on site. Conclusions: Outpatient costs for children initiating ART in Zambia are low and comparable to reported outpatient costs for adults. Outpatient costs and retention in care vary widely by site, suggesting opportunities for efficiency gains. Taking advantage of such opportunities will help ensure that targets for pediatric treatment coverage can be met.

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0067910

DOI: 10.1371/journal.pone.0067910

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