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

摘要: Background There are few published estimates of the cost pediatric antiretroviral therapy (ART) in Africa. Our objective was to estimate outpatient providing ART children remaining care at six public sector clinics Zambia during first three years after initiation, stratified by service delivery site and time on treatment. Methods Data resource utilization (drugs, diagnostics, visits, fixed costs) treatment outcomes (in care, died, lost follow up) were extracted from medical records for 1,334 sites who initiated <15 age between 2006 2011. Fixed variable unit costs (reported 2011 USD) estimated provider’s perspective using level data. Results Median initiation 4.0 years; median CD4 percentage 14%. One year 73% patients remained ranging 60% 91% depending site. The average annual per patient $209 (95% CI, $199–$219), $116 $107–$126) $516 $499–$533) Average decreased as increased. Antiretroviral drugs largest component all (>50%) four sites. At two sites, visits together accounted >50% costs. distribution is slightly skewed, with 3% 13% lower than site. Conclusions Outpatient initiating low comparable reported adults. Outpatient retention vary widely site, suggesting opportunities efficiency gains. Taking advantage such will help ensure that targets coverage can be met.