Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
Parikh, A., Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa; Veenstra, N., Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
Background and objective. The high HIV prevalence in KwaZulu-Natal (KZN) places immense pressure on the health system. The burden of HIV/AIDS on health services is evolving as the epidemic progresses and as antiretroviral treatment becomes more widely available. For health policy makers and managers, timely and appropriate information is needed to facilitate adaptive management of health services. Through longitudinal research covering outpatient health services in KZN we examined the dynamics of the evolving HIV/AIDS burden and the resource implications of this burden, necessary for resource allocation decisions. Methods. Data were collected between 2004 and 2005 in outpatient services across six health facilities in the province. The burden of HIV/ AIDS was measured by assessing the proportion of outpatients presenting as HIV positive, determined by a clinical diagnosis (and test result where available). The burden was also measured by looking at the types of diseases presenting at outpatient facilities. Moreover, the study assessed the burden experienced by health care workers and financial implications for health facilities. Results and conclusions. The study demonstrates that the burden on outpatient services is significant but has not been increasing over time, suggesting that people are not accessing care if and when they need it. However, in terms of resources, this burden has been increasing and shifting from tertiary services to more primary services. In order to accommodate the demands of HIV/AIDS, our focus therefore needs to turn towards outpatient services, in particular at the primary care level.
antiretrovirus agent; acquired immune deficiency syndrome; adult; article; caregiver burden; controlled study; drug cost; female; health care access; health care cost; health care facility; health care personnel; human; Human immunodeficiency virus infection; Human immunodeficiency virus prevalence; information processing; laboratory diagnosis; longitudinal study; major clinical study; male; outpatient; outpatient care; primary medical care; resource allocation; South Africa; tertiary health care; Acquired Immunodeficiency Syndrome; Adult; Ambulatory Care Facilities; Community Health Services; Female; Health Policy; Health Resources; Health Services Accessibility; Health Services Needs and Demand; HIV Infections; Humans; Male; Pilot Projects; Prevalence; South Africa