July 21, 2011

Nurses Providing Primary HIV Care

(Ivanhoe Newswire)-- HIV patients are beginning to seek medical treatment from nurses rather than doctors. Why is this method clinically successful and cost effective? A recent study shows that by transferring primary health care using this strategy, health care improves or maintains patient responses to antiretroviral therapy for 11 percent lower cost than doctor managed hospital-based outpatient treatment.

Lawrence Long from the University of Witwatersrand in Johannesburg, South Africa, conducted a study to test this health care strategy. His findings suggest that this primary health care transfer would increase treatment capacity, shift care from doctors to nurses, and conserve resources without fear of compromising HIV patient outcomes.

Authors of this study collected data from a group of over 700 adult patients with HIV who were initially treated by doctors at the Thembu Lethu Clinic in Johannesburg before they were transferred to a primary health clinic where nurses supervised their treatment. All of the patients in the study were doing well on the treatment at the start of this one year period. In the study the authors found that only 1.7 percent of transferred patients had died compared to 6.2 percent of patients who continued receiving doctor-managed therapy. The average cost per patient for those 12 months was 492 dollars for those transferred to nurse care and 551 dollars for those patients in doctor managed care.

The authors of the study were quoted saying, "In addition to the financial cost savings estimated in this study, transferring patients to nurse-managed, primary-level clinics has the additional advantage of freeing up the time and resources of more highly trained doctors and well-equipped facilities to focus on patients who are not responding to treatment or have other complications." With shifts within the hospital, more health care workers can provide therapy to HIV patients and increase the treatment coverage available to meet the needs of those that have not been met.

SOURCE: PLoS, July 19, 2011