USING PRIVATE MEDICAL SCHEME DATA TO ESTIMATE SOUTH AFRICA’S HIV CARE AND TREATMENT BURDEN BY GEOGRAPHIC AREA

By  Dr. Denise Evans  Dr. Jacqui Miot  Sarah Girdwood  Dr. Lawrence Long  |  | 

In 2017, South Africa had 7.2 million people living with HIV, of whom 61% were on antiretroviral therapy (UNAIDS 2018). While HIV treatment in the public sector is well documented through national electronic medical record systems, such as Tier.Net, DHIS, and the NHLS data warehouse, little is known about the role of the private sector in HIV treatment service delivery (Awsumb et al, IAS 2017). In particular, there are no published geographic data describing the HIV disease burden amongst people accessing healthcare through the private sector.
Private sector records from medical schemes offer the opportunity to analyse a complete history of a HIV positive patient’s interaction with the private healthcare system, including medication, laboratory, consultation, and hospitalization data across multiple diseases, including HIV. Medical scheme data thus overcome some of the limitations of public sector data, such as the lack of a unique patient identifier in public facilities. On the other hand, the value of medical scheme data is limited by the fact that only services for which claims were submitted are included—services paid out of pocket or received in the public sector are not reflected.

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