PMID- 34040269
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220302
IS  - 0197-4254 (Print)
IS  - 0197-4254 (Linking)
VI  - 49
IP  - 1
DP  - 2021 Mar
TI  - Cost-Effectiveness Analysis Combining Medical and Mental Health Services for 
      Older Adults with HIV in New York City.
PG  - 43-56
LID - 10.1007/s11293-021-09697-3 [doi]
AB  - Older adults with the human immunodeficiency virus or HIV (OAWH), people 50 years 
      and older, are aging with the disease and experience low quality of life. Mental 
      health disorders trigger and worsen health inequalities with larger impacts on 
      the quality of life of OAWH. This paper evaluated two rival health interventions 
      using a standard decision-analytic model and quantified the cost per 
      quality-adjusted life-years (QALY) to understand the differential in cost and 
      effectiveness of an additional unit of perfect health. HIV medical care was 
      compared with a combined strategy that includes both HIV medical and behavioral 
      care. Primary data from a convenience sample (n=139) collected in New York City 
      and outcomes for healthy older adults from the literature were used in this 
      study. The incremental cost-effectiveness ratio (ICER) evaluating the economic 
      cost and health benefits of the new intervention was $36,166 per QALY, which is 
      less than the willingness to pay ($75,000). The ICER for Hispanics was $35,325 
      and for White/Caucasians was $40,499. Integrated medical plus behavioral care is 
      cost-effective and improves quality of life among OAWH. Given the high rates of 
      mental health disorders along with an underutilization of behavioral care among 
      OAWH, timely and effective mental health programs are paramount to increase 
      quality of life.
FAU - DelaCruz, Juan J
AU  - DelaCruz JJ
AD  - Lehman College - City University of New York 250 Bedford Park Blvd W, Bronx, NY.
FAU - Giannikos, Christos
AU  - Giannikos C
AD  - The Graduate Center - City University of New York 365 Fifth Avenue, New York, NY.
FAU - Kakolyris, Andreas
AU  - Kakolyris A
AD  - Manhattan College 4513 Manhattan College Parkway, Room DLS 505, Bronx, NY.
FAU - Utzinger, Robert C
AU  - Utzinger RC
AD  - Graduate Center - City University of New York365 Fifth Avenue, New York, NY.
FAU - Karpiak, Stephen E
AU  - Karpiak SE
AD  - ACRIA Center on HIV and Aging at GMHC & NYU-College of Nursing 307 West 38th 
      Street, New York, NY.
LA  - eng
GR  - R01 DA041063/DA/NIDA NIH HHS/United States
GR  - R25 MH080665/MH/NIMH NIH HHS/United States
PT  - Journal Article
DEP - 20210308
PL  - United States
TA  - Atl Econ J
JT  - Atlantic economic journal : AEJ
JID - 101085270
PMC - PMC8143031
MID - NIHMS1698748
OTO - NOTNLM
OT  - Cost-Effectiveness
OT  - HIV
OT  - I14
OT  - Mental Health JEL: I11
OT  - Older Adults
OT  - Quality of Life
COIS- Conflicts of Interest/Competing Interest We, the authors, do not have any 
      conflict of interest.
EDAT- 2021/05/28 06:00
MHDA- 2021/05/28 06:01
PMCR- 2022/03/01
CRDT- 2021/05/27 06:35
PHST- 2021/05/27 06:35 [entrez]
PHST- 2021/05/28 06:00 [pubmed]
PHST- 2021/05/28 06:01 [medline]
PHST- 2022/03/01 00:00 [pmc-release]
AID - 10.1007/s11293-021-09697-3 [doi]
PST - ppublish
SO  - Atl Econ J. 2021 Mar;49(1):43-56. doi: 10.1007/s11293-021-09697-3. Epub 2021 Mar 
      8.