AIDSWEEKLY Plus; Monday, December 07, 2009
Staff Medical Writers

2009 DEC 7 - (NewsRx.com) -- According to a study from the United States, "Lower-income countries face severe health worker shortages. Recent evidence suggests that this problem can be mitigated by task-shifting--delegation of aspects of health care to less specialized health workers."

"We estimated the potential impact of task-shifting on costs of antiretroviral therapy (ART) and physician supply in Uganda. The study was performed at the Infectious Diseases Institute (IDI) clinic, a large urban HIV clinic. We built an aggregate cost-minimization model from societal and Ministry of Health (MOH) perspectives. We compared physician-intensive follow-up (PF), the standard of care, with two methods of task-shifting: nurse-intensive follow-up (NF) and pharmacy-worker intensive follow-up (PWF). We estimated personnel and patient time use using a time-motion survey. We obtained unit costs from IDI and the literature. We estimated physician personnel impact by calculating full time equivalent (FTE) physicians saved. We made national projections for Uganda. Annual mean costs of follow-up per patient were $59.88 (societal) and $31.68 (medical) for PF, $44.58 (societal) and $24.58 (medical) for NF and $18.66 (societal) and $10.5 (medical) for PWF. Annual national societal ART follow-up expenditure was $5.92 million using PF, $4.41 million using NF and $1.85 million using PWF, potentially saving $1.51 million annually by using NF and $4.07 million annually by using PWF instead of PF. Annual national MOH expenditure was $3.14 million for PF, $2.43 million for NF and $1.04 for PWF, potentially saving $0.70 million by using NF and $2.10 million by using PWF instead of PF. Projected national physician personnel needs were 108 FTE doctors to implement PF and 18 FTE doctors to implement NF or PWF. Task-shifting from PF to NF or PWF would potentially save 90 FTE physicians, 4.1% of the national physician workforce or 0.3 FTE physicians per 100,000 population," wrote J.B. Babigumira and colleagues, University of Washington (see also Antiretrovirals).

The researchers concluded: "Task-shifting results in substantial cost and physician personnel savings in ART follow-up in Uganda and can contribute to mitigating the heath worker crisis."

Babigumira and colleagues published their study in BMC Health Services Research (Potential impact of task-shifting on costs of antiretroviral therapy and physician supply in Uganda. BMC Health Services Research, 2009;9:192).

For more information, contact J.B. Babigumira, University of Washington, School Pharmacy, Pharmaceutical Outcomes Research & Policy Program, Seattle, WA 98195, USA.

Publisher contact information for the journal BMC Health Services Research is: Biomedical Central Ltd., 236 Grays Inn Rd., Floor 6, London WC1X 8HL, England.

Keywords: City:Seattle, State:WA, Country:United States, AIDS/HIV, Antiretrovirals, Antivirals, Infectious Diseases, Pharmaceuticals, Regulatory Actions, Therapy, Treatment

This article was prepared by AIDS Weekly editors from staff and other reports.

Ref: Babigumira JB, Castelnuovo B, Lamorde M, et al. “Potential impact of task-shifting on costs of antiretroviral therapy and physician supply in Uganda”, BMC Health Serv Res. 2009 Oct 21;9:192.

2009-12-07
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