Avoidable workload of care for patients living with HIV infection in Abidjan, Côte d’Ivoire: A cross-sectional study

Viet-Thi Tran, Mariam Mama Djima, Eugene Messou, Jocelyne Moisan, Jean-Pierre Grégoire and Didier K Ekouevi

PLOS ONE, 2018, vol. 13, issue 8, 1-15

Abstract: Objective: People living with HIV infection (PLWHIV) in Sub-Saharan Africa cope with an increasing workload of care (doctor visits, lab tests, medication management, refills, etc.) in a context of poor health service organization. We aimed to describe the workload of care for PLWHIV in Sub-Saharan Africa and assess to what extent simple adjustments in care organization could reduce this workload of care. Methods: Adult PLWHIV under antiretroviral treatment for at least 1 year were recruited in three centers (two public, one private) in Abidjan, Côte d’Ivoire. Using methods inspired from sociology, we precisely described all health-related activities (HRAs) performed by patients, in 1 month, in terms of time, money and opportunity costs. Then, we assessed the theoretical avoidable workload of care if patients’ visits and tests had been grouped on the same days. Results: We enrolled 476 PLWHIV in the study. Patients devoted 6.7 hours (SD = 6.3), on average, in HRAs per month and spent 5% (SD = 11) of their monthly revenue, on average, on health activities. However, we found great inter-patient heterogeneity in the mixture of activities performed (managing medications; dietary recommendations; visits, tests, support groups; administrative tasks; etc.) and their time allocation, temporal dispersion and opportunity costs (personal, familial, social or professional costs). For 22% of patients, grouping activities on the same days could reduce both time and cost requirements by 20%. Conclusion: PLWHIV in Côte d’Ivoire have a heavy workload of care. Grouping visits and tests on the same days may be a simple and feasible way to reduce patients’ investment of time and money in their care.

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0202911

DOI: 10.1371/journal.pone.0202911

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