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American Journal of Public Health logoLink to American Journal of Public Health
. 1990 Jul;80(7):835–839. doi: 10.2105/ajph.80.7.835

Effect of changing patterns of care and duration of survival on the cost of treating the acquired immunodeficiency syndrome (AIDS).

G R Seage 3rd 1, S Landers 1, G A Lamb 1, A M Epstein 1
PMCID: PMC1404991  PMID: 2356908

Abstract

We performed a two-year cost of illness study of 240 AIDS patients (55 percent of all Massachusetts cases) diagnosed and treated at five hospitals from March 1984 through February 1986. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of inpatient and outpatient hospital records. The yearly inpatient cost per patient decreased by 28 percent from $38,369 in year one to $27,714 in year two. These changes were related to shorter lengths of stay (from 20.6 days to 16.8 days per hospitalization, mean difference of 3.8 days, 95% CI of the difference -.2, 7.8), and less costly hospitalizations (from $12,463 to $9,957, mean difference of $2,506, 95% CI of the difference $135, $4,877). The probability of hospitalization, however, was similar in both years. These patterns of care were still evident after controlling for transmission category, race, site, mortality, insurance, age, gender, number and type of opportunistic diseases and time since diagnosis. Although the cost per patient per year decreased between years one and two, median survival increased by 70 percent (from 10 to 17 months). Hence overall estimated lifetime costs increased by 24 percent.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrulis D. P., Beers V. S., Bentley J. D., Gage L. S. The provision and financing of medical care for AIDS patients in US public and private teaching hospitals. JAMA. 1987 Sep 11;258(10):1343–1346. [PubMed] [Google Scholar]
  2. Barré-Sinoussi F., Chermann J. C., Rey F., Nugeyre M. T., Chamaret S., Gruest J., Dauguet C., Axler-Blin C., Vézinet-Brun F., Rouzioux C. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. 1983 May 20;220(4599):868–871. doi: 10.1126/science.6189183. [DOI] [PubMed] [Google Scholar]
  3. Creagh-Kirk T., Doi P., Andrews E., Nusinoff-Lehrman S., Tilson H., Hoth D., Barry D. W. Survival experience among patients with AIDS receiving zidovudine. Follow-up of patients in a compassionate plea program. JAMA. 1988 Nov 25;260(20):3009–3015. [PubMed] [Google Scholar]
  4. Fischl M. A., Richman D. D., Grieco M. H., Gottlieb M. S., Volberding P. A., Laskin O. L., Leedom J. M., Groopman J. E., Mildvan D., Schooley R. T. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med. 1987 Jul 23;317(4):185–191. doi: 10.1056/NEJM198707233170401. [DOI] [PubMed] [Google Scholar]
  5. Hardy A. M., Rauch K., Echenberg D., Morgan W. M., Curran J. W. The economic impact of the first 10,000 cases of acquired immunodeficiency syndrome in the United States. JAMA. 1986 Jan 10;255(2):209–211. [PubMed] [Google Scholar]
  6. Hellinger F. J. Forecasting the personal medical care costs of AIDS from 1988 through 1991. Public Health Rep. 1988 May-Jun;103(3):309–319. [PMC free article] [PubMed] [Google Scholar]
  7. Kaplowitz L. G., Turshen I. J., Myers P. S., Staloch L. A., Berry A. J., Settle J. T. Medical care costs of patients with acquired immunodeficiency syndrome in Richmond, Va. A quantitative analysis. Arch Intern Med. 1988 Aug;148(8):1793–1797. [PubMed] [Google Scholar]
  8. Lafferty W. E., Hopkins S. G., Honey J., Harwell J. D., Shoemaker P. C., Kobayashi J. M. Hospital charges for people with AIDS in Washington State: utilization of a statewide hospital discharge data base. Am J Public Health. 1988 Aug;78(8):949–952. doi: 10.2105/ajph.78.8.949. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Levy J. A., Hoffman A. D., Kramer S. M., Landis J. A., Shimabukuro J. M., Oshiro L. S. Isolation of lymphocytopathic retroviruses from San Francisco patients with AIDS. Science. 1984 Aug 24;225(4664):840–842. doi: 10.1126/science.6206563. [DOI] [PubMed] [Google Scholar]
  10. Levy J. A., Hoffman A. D., Kramer S. M., Landis J. A., Shimabukuro J. M., Oshiro L. S. Isolation of lymphocytopathic retroviruses from San Francisco patients with AIDS. Science. 1984 Aug 24;225(4664):840–842. doi: 10.1126/science.6206563. [DOI] [PubMed] [Google Scholar]
  11. Rothenberg R., Woelfel M., Stoneburner R., Milberg J., Parker R., Truman B. Survival with the acquired immunodeficiency syndrome. Experience with 5833 cases in New York City. N Engl J Med. 1987 Nov 19;317(21):1297–1302. doi: 10.1056/NEJM198711193172101. [DOI] [PubMed] [Google Scholar]
  12. Scitovsky A. A., Cline M., Lee P. R. Medical care costs of patients with AIDS in San Francisco. JAMA. 1986 Dec 12;256(22):3103–3106. [PubMed] [Google Scholar]
  13. Seage G. R., 3rd, Landers S., Barry A., Groopman J., Lamb G. A., Epstein A. M. Medical care costs of AIDS in Massachusetts. JAMA. 1986 Dec 12;256(22):3107–3109. [PubMed] [Google Scholar]
  14. Thomas Emily H., Fox Daniel M. The cost of AZT. AIDS Public Policy J. 1987 Spring-Summer;2(2):17–21. [PubMed] [Google Scholar]

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