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Comparison of HIV-infected patients' characteristics, healthcare resources use and cost between native and migrant patients

Wasserfallen, Jean-Blaise ; Hyjazi, Alexandre ; Cavassini, Matthias

In: International Journal of Public Health, 2009, vol. 54, no. 1, p. 5-10

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    Title
    • Comparison of HIV-infected patients' characteristics, healthcare resources use and cost between native and migrant patients
    Author
    • Wasserfallen, Jean-Blaise. Institute of Health Economics and Management, University Hospital Center and University of Lausanne, Lausanne, Switzerland
    • Hyjazi, Alexandre. Institute of Health Economics and Management, University Hospital Center and University of Lausanne, Lausanne, Switzerland
    • Cavassini, Matthias. Service of Infectious Diseases, University Hospital Center and University of Lausanne, Lausanne, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • International Journal of Public Health, 2009, vol. 54, no. 1, p. 5-10. Birkhäuser-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:318560
    Summary
    Objectives:: To assess whether patients' characteristics and healthcare resources consumption and costs were different between native and migrant populations in Switzerland. Methods:: All adult patients followed-up in the Swiss HIV-cohort study in our institution during 2000-2003 were considered. Patients' characteristics were retrieved from the cohort database. Hospital and outpatient resource use were extracted from individual charts and valued with 2002 tariffs. Results:: The 66 migrants were younger (29 ± 8years versus 37±11, p < 0.001), less often of male gender (38 % versus 70 %, p < 0.001), predominantly infected via heterosexual contact (87 % versus 52 %, p < 0.01), with lower mean CD4 level at enrolment (326 ± 235 versus 437± 305, p = 0.002) than their 200 native counterparts. Migrants had fewer hospitalizations, more frequent outpatient visits, laboratory tests, and lower total cost of care per year of follow-up (€ 2′215 ± 4′206 versus 4′155 ± 12′304, p = 0.037). Resource use and costs were significantly higher in people with < 200 CD4 cell counts in both groups. Conclusions:: Migrant population had more advanced disease, more outpatient visits but less hospitalizations, resulting in lower costs of care when compared with native population