How labour intensive is a doctor-based delivery model for antiretroviral treatment (ART)? Evidence from an observational study in Siem Reap, Cambodia
2007

Doctor-Based Delivery Model for Antiretroviral Treatment in Cambodia

Sample size: 1423 publication Evidence: moderate

Author Information

Author(s): Wim Van Damme, Kheang Soy Ty, Bart Janssens, Katharina Kober

Primary Institution: Institute of Tropical Medicine, Antwerp, Belgium

Hypothesis

How labour intensive is a doctor-based delivery model for antiretroviral treatment (ART)?

Conclusion

ART is labour intensive, but important reductions in doctor-time per patient can be realized during scaling-up.

Supporting Evidence

  • Doctor-time needed per patient was reduced by 14% to 33% from 2004 to 2005.
  • In 2004, 2.06 full-time equivalent (FTE) doctors were needed for 522 patients on ART.
  • By 2013, the clinic will need between 2 and 5 FTE doctors for ART.
  • In a hypothetical district in sub-Saharan Africa, between 4 and 11 FTE doctors would be needed to cover 50% of ART needs.

Takeaway

This study looked at how much time doctors spend helping people with HIV get treatment. They found that over time, doctors can spend less time with each patient while still giving good care.

Methodology

The study documented doctor-time use for ART in a clinic over two years and estimated future needs based on patient survival and doctor-time reduction assumptions.

Limitations

The extrapolation of findings may not be applicable to all contexts, especially in sub-Saharan Africa due to differences in healthcare systems.

Participant Demographics

Patients included 1158 HIV positive individuals, with a median CD4 count of 50 cells/μl at initial assessment.

Digital Object Identifier (DOI)

10.1186/1478-4491-5-12

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