Problem Background
HIV and AIDS are some of the most pressing health issues worldwide. The main issue concerning HIV infection is that the condition is incurable. However, owing to accessibility to exceptional HIV early detection, treatment, and care, especially for accidental infections, HIV infection has evolved into a manageable chronic health disease, allowing those who have it to live long and healthy lives (WHO, 2023). As a result, clinical programs aimed at supporting vulnerable population groups are essential for building resilience among patients and helping them through appropriate treatment.
Program Description
The program under evaluation is a community-based clinical program that offers treatment, support, and counseling to patients diagnosed with HIV or AIDS. The initiative will provide holistic care to patients from all backgrounds, regardless of age, gender, or other factors. The program aims to improve patients’ quality of life through proper treatment. Patients will additionally receive moral support and access to community resources.
Type of Evaluation
The evaluation used for the program assessment is cost-effectiveness and cost analysis. Before program adoption, it would be ideal to assess both cost and effectiveness (HWC-577, 2023). Costs are always a crucial factor in the development, execution, and delivery of programs (HWC-577, 2023).
Cost information gives the knowledge to aid in improved decision-making (HWC-577, 2023). The most effective programs deliver the best outcomes at the lowest possible cost (HWC-577, 2023). Therefore, evaluation based on collecting and interpreting cost information can help understand whether the program will yield results and be successful.
Considering that the program’s description has already been introduced, emphasizing the research question, the next step in the evaluation will be computing the costs associated with the program. Then, collecting data on the clinical program’s outcomes will be essential. Finally, data interpretation will be required to understand whether there were positive or negative results. A cost-benefit analysis will be the concluding point that offers the final insight into the program’s viability.
Assumptions
The evaluation of the program is based on several assumptions that concern financial, patient, and community aspects. The first assumption is that the program has financial stability and all necessary resources, including trained staff, medical supplies, and funding (Govil et al., 2022). There must be sufficient financing for a clinical program, and the hospital administration must support it. To safeguard patients from harmful, ineffective, and low-quality healthcare services, a suitable number of staff members, equipment, and other resources is needed (Govil et al., 2022). Therefore, financial aspects are essential to the success of the program.
Another assumption is that the program is accessible to all patients living with HIV and AIDS in the community. Individuals are more inclined to obtain the essential medical attention needed to maintain their disease under control when they have appropriate access to care (Perry et al., 2021). By doing so, issues can be avoided, and health results can be enhanced. Thus, ensuring that individuals know the program, its services, and its benefits is essential.
The last assumption is that patients diagnosed with HIV or AIDS are willing to engage in the program and seek treatment and further help there. Without motivation to participate in the program, there will be minimal chances for success.
External Factors
Another step when evaluating the clinical program for HIV and AIDS patients is to identify and interpret external factors. In general, the sociocultural setting, physical surroundings, or population demographics can all impact how well an implementation goes (Ziemann et al., 2019). When reviewing the program under question, the first external factor to be considered is the social one. In this situation, the clinical program must be culturally sensitive and respect the social norms and values of the community where the intervention occurs.
Another external factor that must be mentioned is the economic one. External economic factors can significantly reduce the program’s effectiveness due to poverty. However, governmental funding and grants can be especially helpful in determining the success of the clinical initiative. As a result, such changes in the environment and factors are crucial to monitor, which will help the program managers adapt quickly.
The last external factor to consider for the given program is cultural. When analyzing and executing the program, it is essential to consider whether it will be effective in reducing the prevalence of HIV or AIDS in the community. Addressing critical health challenges is, therefore, important for the program. Consequently, by considering all of the mentioned factors and adapting to them, it will be possible to ensure not only the success of the program but also its sustainability in the long run.
Inputs
In addition to reviewing external factors that can influence the program’s course, paying attention to the initiative’s inputs is critical. Inputs refer to the resources required for the program’s execution, which can involve staff, equipment, facilities, and other resources that may be necessary to run the program correctly. A careful review of the inputs can help understand whether the allocation of funds to each type of input is rational and can contribute to the effectiveness of the clinical program.
The first point concerning inputs is the personnel and costs associated with it. Personnel costs refer to expenditures that involve salaries, benefits, and training costs for clinical staff. As seen from Table 1, the estimated overall cost of the personnel is $320,000—another type of input and cost concern for facilities, which involves rent, utilities, and maintenance expenditures. The estimated total expenditures on this component are $170,000.
Then, when considering the equipment costs, it is essential to consider not only the direct expenses of the medical equipment but its maintenance as well, which was estimated to cost approximately $230,000. Finally, as seen in Table 2, other costs must also be considered, including administrative and operational expenditures. Here, the estimated amount allocated to other costs is $130,000.
Overall, the total funding expected to run a clinical program for patients with HIV and AIDS is $850,000. The cost analysis can serve as a foundation for future budgeting and planning, and share insights into financial implications that can follow the execution of such a clinical program. Nevertheless, considering the significant amount of funding that must be allocated toward the successful completion of the program, it is essential to consider that the benefits can outweigh the costs.
Activities
Furthermore, after discussing external factors and inputs that will facilitate the flow of operations within the program, it is essential to pay attention to the activities that will constitute it. The first activity to which the program will be dedicated is a medical treatment offered to patients diagnosed with HIV and AIDS. Although there is no direct cure that can help an individual heal from the condition, there are medications that can alleviate the symptoms and stop the exacerbation of the disease. For instance, antiretroviral medications are commonly used to treat the conditions (Hardy, 2019).
Moreover, another activity that will constitute the program will be counseling delivered to the patients. Two overarching goals of HIV and AIDS counseling are to avoid the spread of HIV and to support those who are both directly and indirectly impacted by the virus (Hardy, 2019). These two objectives must be the focus of HIV counseling since behavioral changes can stop the global transmission of HIV.
Another activity the program will offer is providing patients with community resources to help them in their treatment process. The program will primarily aim to support those from low-income communities or uninsured individuals through local resources. Therefore, the program can be viewed as effective with such a holistic approach to patient treatment, offering both moral support and treatment.
Outputs
Outputs are the following section that must be considered since outputs refer to the results that can be achieved with the help of the incorporated activities. On a micro level, outputs can concern patients who were diagnosed with HIV or AIDS. First, individuals participating in the program can experience significant improvements in their mental and physical well-being.
Second, the outputs can additionally demonstrate improvements in patients’ quality of life. When eliminating manifestations of condition symptoms and boosting physical well-being, patients can see specific areas of their life being of better quality. Finally, aside from increased patient satisfaction and improved health outcomes, hospitalizations in the local areas can be reduced. By educating patients through counseling, explaining the intricacies of the condition, and offering adequate treatment plans, hospitalizations can be minimized with the program’s help.
On a macro level, outputs can involve improving the communities through decreasing HIV transmission. Counseling services and spreading awareness of the condition can help reduce instances of HIV spreading. Therefore, when evaluating the program’s outcomes, it is crucial to look at several expected outputs. By analyzing the components holistically, it is feasible to gain deeper insights into the factors contributing to program effectiveness and areas requiring more attention.
Outcomes and Measures
Moving to another section, outcomes and measures, it is vital to recognize that the effectiveness and success of the program will depend on the collected data and measures used to interpret data. For this program, the first measure will be identifying the number of patients who enrolled in the program. Such an indicator will help the program managers understand the initiative’s reach. If the reach is high, it will indicate that the process of attracting individuals diagnosed with HIV or AIDS was successful.
Another measure that will be applied to analyze the outcomes is the number of patients who completed the treatment. Although the number of overall participants is essential, it is more important to see the program’s success rate. If the number of individuals who completed the therapy is high and increasing, the program effectively treats the patients.
However, besides these indicators, looking at those who experienced adverse effects is crucial to view the whole picture. Such an indicator will allow us to measure the effectiveness and safety of the program. Therefore, the number of patients with adverse effects must be minimal.
Furthermore, another indicator must be used to measure the program’s outcomes. In the case of patients diagnosed with HIV and AIDS, analyzing the number of those who experienced disease progression is vital. The measure will be necessary for understanding the program’s efficacy, which is why the number of such patients must also be low or minimal.
Finally, the most critical indicator in the study will be the number of patients who experienced viral suppression. This is the program’s goal and the demonstration of its success. The program should strive to have as many patients with viral suppression as possible.
Cost-Effectiveness
Finally, the program’s effectiveness analysis will be finished by employing a cost-effectiveness ratio. To compute the ratio, it is crucial first to find the total costs associated with the program. In the given situation, the program’s total cost is the sum of personnel costs, facilities costs, equipment costs, and other expenses. As was mentioned previously, total personnel costs are $320,000, total facilities costs are $170,000, estimated equipment costs are $230,000, and other expenses amount to $130,000. In total, the expenditures associated with the execution of the program for patients diagnosed with HIV and AIDS are $850,000.
The next step is to use the measures discussed in the previous section, which is dedicated to outcomes and measures. Hypothetical and realistic points can be used to evaluate the program’s effectiveness. For instance, given that it is a new program, 100 patients can be enrolled in the initiative, with 90 completing the course of treatment. Out of those 90 individuals who completed the treatment and received the healthcare services in terms of community support, ten experienced adverse effects, and five experienced disease progression.
Meanwhile, 75 patients from the program achieved viral suppression. As a result, the cost-effectiveness ratio can be measured by dividing the program’s cost by the number of patients who had successful outcomes. Consequently, only $11,300 per patient will be spent to achieve viral suppression, optimal education on condition management, and improved awareness.
Anticipated Challenges
Nevertheless, there are specific anticipated challenges that can affect the effectiveness of the program. One of the challenges faced during evaluation is the inability to retrieve accurate and reliable data, which is essential for adequate assessment. This can happen because the program deals with subjective data as well.
The first challenge can additionally lead to the second one, which concerns measuring intangible outcomes. In this situation, measuring patient satisfaction can be challenging. Nevertheless, it is crucial to include such estimates in the program outcomes since they provide a clear understanding of whether the needs of patients were met. As a result, it is essential to address the challenges mentioned to obtain a comprehensive and reliable evaluation.
Other challenges that can be involved in the execution of the program can be external factors, such as changes in funding. The result of such factors can be reduced program effectiveness and performance, as well as limited opportunities. The final challenge that can be anticipated is the inability to compare the given program to other HIV and AIDS-related programs due to differences in structures and populations. Yet, addressing such issues is essential for the program’s viability and sustainability in the long run.
References
Govil, D., Mishra, R. C., Chaudhry, D., & Todi, S. (2022). Critical care update. Jaypee Brothers Medical Publishers.
Hardy, W. D. (2019). Fundamentals of HIV medicine. Oxford University Press.
HWC-577. (2023). Chapter 10: Cost-effectiveness and cost analysis [Lecture].
Perry, A. G., Hall, A., Stockert, P. A., & Potter, P. A. (2021). Potter & Perry’s essentials of nursing practice. Elsevier Health Sciences.
WHO. (2023). HIV and AIDS. World Health Organization. Web.
Ziemann, A., Brown, L., Sadler, E., Ocloo, J., Boaz, A., & Sandall, J. (2019). Influence of external contextual factors on the implementation of health and social care interventions into practice within or across countries—a protocol for a ‘best fit’ framework synthesis. Systematic Reviews, 8(1), 1-9. Web.