While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .
Reduction in hospitalization costs, morbidity, disability, and mortality in patients with aids treated with protease inhibitors.
BACKGROUND The objective of this study was to analyze hospitalization costs , morbidity , disability , and mortality in patients with acquired immunodeficiency syndrome ( AIDS ) treated with protease inhibitors ( PI ) .  METHODS This is a self-controlled , ambispective study of a total of 581 patients with human immunodeficiency virus (HIV)/AIDS seen at the Hospital de Infectología , Centro Médico La Raza , IMSS , in Mexico City during 1997 . A total of 210 ( 36.14 % ) patients initiated protease inhibitor ( PI ) treatment at the onset of the study . Thirty-eight patients satisfied the inclusion criteria for this study and were analyzed retrospectively during the year prior to PI treatment , and then prospect ively throughout the year on PI treatment . As concerns main outcome measures , financial costs , number of hospitalizations , number of infections , and productivity and laboratory parameters ( CD4(+ ) counts and viral load ) were analyzed during the year prior to PI treatment and then prospect ively during the year on PI prescription . Our hypothesis was that the hospital costs , morbidity , disability , and mortality of patients with AIDS decreased while on PI treatment . RESULTS During the year prior to PI prescription , the 38 patients enrolled in the study were admitted on a total of 59 occasions ( 1.55 hospitalizations/patient ) , whereas during the year on PI therapy , all 38 patients had only seven admissions ( 0.18 hospitalizations/patient ) . Hospitalization costs decreased 35 % when annual PI costs for the 38 patients studied were taken into account . The number of microorganisms detected during hospitalization decreased from 24 prior to PI to five on PI . The number of disability days involved in patients on PI decreased significantly ( p < 0.0002 ) . None of the 38 patients studied died during the year of follow-up under PI treatment . Mortality decreased significantly , from 116/481 ( 23.2 % ) in 1996 , to 77/581 ( 13.2 % ) in 1997 , to 40/740 ( 6.4 % ) in 1998 . There were no deaths among the 38 patients studied during the 1-year follow-up period ; when the observation period was extended 1 additional year , only one patient died ( 2.63 % ) . Only six ( 3.48 % ) of the 172 PI-treated patients with AIDS not included in the study died during the same period . CD4(+ ) cell counts increased from 190.56 + /- 169.5 cells/mm(3 ) to 235.00 + /- 112.65 cells/mm(3 ) ( p < 0.05 ) after 12 months of PI treatment . Viral loads decreased from 5 logs to 2.4 logs at 12 months of PI treatment ( p < 0.001 ) . CONCLUSIONS Introduction of PI to antiretroviral treatment in patients with AIDS was associated with a lower rate of hospital admissions , lower costs , and a lesser number of infections/year , disabilities , and mortalities . Increase of CD4(+ ) cell counts and decrease in viral loads in the 38 patients were associated with decreased morbility and mortality
While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .