ArticleBMJ open2026
Cost-effectiveness of differentiated HIV service delivery in North Wollo, Ethiopia: a retrospective study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferentiated service delivery (DSD) models have been introduced to optimise HIV care by tailoring services to patient needs, but evidence on their cost-effectiveness in Ethiopia is limited.
objectiveTo evaluate the cost-effectiveness of DSD models for HIV care compared with standard of care (SOC) in North Wollo, Ethiopia. STUDY
designRetrospective economic evaluation using bottom-up microcosting from a healthcare provider perspective.
settingOne hospital and three health centres in North Wollo Zone, Ethiopia, from January 2024 to December 2024.
participants786 adults (≥18 years) on antiretroviral therapy, including 393 receiving DSD (across nine models: 6-month multimonth dispensing, 3-month multimonth dispensing, appointment spacing, community antiretroviral therapy (ART) groups (CAG), FastTrack, maternal and child health, peer-led, adolescent groups and key population models) and 393 receiving SOC.
main outcome measuresTotal annual cost per patient (USD), retention in care at 12 months (%) and incremental cost-effectiveness ratios (ICERs) expressed as cost per additional patient retained. STATISTICAL ANALYSIS: Costs were annualised at a 3% discount rate. ICERs were calculated comparing each DSD model to SOC. Deterministic one-way sensitivity analysis (±20% for medication cost and retention rate) assessed robustness.
resultsSOC had the highest annual cost per patient (US$295) and lowest retention (76.6%). All DSD models were dominant (lower cost, higher retention) with negative ICERs. CAG was the most cost-effective (US$199 per patient; 93.0% retention; ICER -5.85), followed by FastTrack (US$212; 92.9%; -5.09) and adolescent groups (US$238; 90.5%; -4.10). Sensitivity analyses confirmed robustness; no scenario reversed dominance.
conclusionDSD models, particularly CAG, FastTrack and adolescent groups, provide more cost-effective HIV care than SOC in Ethiopia by achieving higher retention at lower costs. Scaling up these models could optimise resource allocation and reduce health system burden.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.