- 作者：Bach Xuan Tran ; Long Thanh Nguyen
- 关键词：Methadone maintenance ; HIV/AIDS ; Drug users ; Health care utilization ; Out-of-pocket ; Vietnam
- 刊名：The International Journal of Drug Policy
- 出版年：November, 2013
- 年：2013
- 卷：24
- 期：6
- 页码：e105-e110
- 全文大小：784 K
Background
This study assessed the impact of methadone maintenance treatment (MMT) on health utility, health care service utilization, and out-of-pocket (OOP) health expenditure in drug users with HIV/AIDS in Vietnam.Methods
Using the 2012 Vietnam HIV Service Users Survey data, a post-evaluation was designed to compare 121 MMT patients with 347 non-MMT patients who were matched using propensity scores of MMT covariates. Health utility was measured using the EuroQOL - five dimensions - five levels (EQ-5D-5L) and a visual analogue scale (EQ-VAS).
Results
The mean EQ-5D-5L single index and EQ-VAS score of MMT patients were 0.68 (95% CI = 0.64-0.73) and 71.5% (95% CI = 68.2-74.9). Compared with the control group, the adjusted differences in health utility were 0.08 and 4.43% (p = 0.07), equivalent to 12.1% and 6.5% increases during MMT. There was a 45.9% decrease in the frequency of health care service utilization that was attributable to MMT. Although, antiretroviral treatment and MMT services were free-of-charge, MMT and non-MMT patients still paid their OOP for health care for averagely US$ 16.3/month and US$ 28.9/month. The adjusted difference between the two groups was US$ 19.3/month ($ 231.6/year) that equivalents to a reduction of 66.7% in OOP health expenditure related to MMT.
Conclusion
MMT was associated with a clinically important difference in health utility, large reductions in health care service utilization and OOP health expenditure in HIV-positive drug users. Scaling up MMT in large drug-using population could help improve the outcomes of HIV/AIDS interventions and reduce economic vulnerability of affected households.