Abstract
To obtain better understanding of the nature and cost of health care related to human immunodeficiency virus (HIV) infection, medical payment records were analyzed for 204 men, women, and children older than 60 months who had indications of HIV infection. The records were those of Michigan Medicaid, the General Assistance Medical Program, and the Resident County Hospitalization Program, with service dates on or after January 1, 1984, and which were processed by November 30, 1987. Patient payment records were coded according to whether the patient's condition was considered to be pre-HIV, HIV unrelated, possibly HIV related, or HIV related. Average monthly payments were found to be $150 for pre-HIV patient payment records, $114 for those HIV unrelated, $57 for those possibly related, and $1,213 for those related to HIV infection. HIV-related monthly payments rose from about $1,500 per month in the period 3 months prior to the patient's death to more than $8,000 in the last month of life. Men were found to have twice as many claims as women, and men's claims cost about three times as much. A higher percentage of women than men (91 percent versus 37 percent) received pre-HIV paid services, indicating a higher percentage of women were at least initially receiving Medicaid for reasons other than an HIV-related disability. Diagnostic categories that accounted for the bulk of the HIV-related health care utilization included infectious and parasitic diseases, acquired immunodeficiency syndrome, diseases of the respiratory system, and non-HIV-specific immunity disorders. Inpatient hospitalization accounted for more than 75 percent of the payments, followed by physician costs (11 percent), pharmacy costs (5 percent), and outpatient costs (3 percent). A total of 45, or about 22 percent of the recipients, received zidovudine (AZT) prescriptions at an average monthly cost of $404.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andrulis D. P., Beers V. S., Bentley J. D., Gage L. S. State Medicaid policies and hospital care for AIDS patients. Health Aff (Millwood) 1987 Winter;6(4):110–118. doi: 10.1377/hlthaff.6.4.110. [DOI] [PubMed] [Google Scholar]
- Fox D. M., Thomas E. H. AIDS cost analysis and social policy. Law Med Health Care. 1987;15(4):186–211. doi: 10.1111/j.1748-720x.1987.tb01032.x. [DOI] [PubMed] [Google Scholar]
- Guinan M. E., Hardy A. Epidemiology of AIDS in women in the United States. 1981 through 1986. JAMA. 1987 Apr 17;257(15):2039–2042. [PubMed] [Google Scholar]
- 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]
- Hellinger F. J. National forecasts of the medical care costs of AIDS: 1988-1992. Inquiry. 1988 Winter;25(4):469–484. [PubMed] [Google Scholar]
- 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]
- Scitovsky A. A., Rice D. P. Estimates of the direct and indirect costs of acquired immunodeficiency syndrome in the United States, 1985, 1986, and 1991. Public Health Rep. 1987 Jan-Feb;102(1):5–17. [PMC free article] [PubMed] [Google Scholar]