HIV

HIV

HIV

The good news about HIV care in the United States is that treatment costs are not prohibitive - the average cost per patient is equal to about $ 20,000 a year. Although these costs represent an increasing burden on the public sector are still lower than the costs of treating major diseases. The bad news, however, is that half to two thirds of American adults infected with HIV do not receive regular medical care, and fewer still receive anti-HIV therapy later in life.

These are the main findings in the initial report of the costs of HIV and Services Utilization Study (HCSUS), the first global effort to collect information on a nationally representative sample of people receiving care for HIV infection. Sponsored by the Agency for Health Care Policy Research, the study is being conducted by RAND in conjunction with a consortium of research institutions, public and private.

The report is based on data from the first round of survey interviews with 2,864 randomly selected patients to accurately represent the set of "reference population" - adults in the 48 states with HIV infection who received care during the first two months 1996. The study excluded adults treated at the military prison, and facilities of the emergency room and excluded children. The interviews sought information primarily about the nature and cost of care, as well as patient characteristics.

Characteristics of HIV care

The study team found that 231,400 adults were treated during the first two months of 1996. Based on this figure, the team estimates that about 335,000 American adults infected with HIV saw a doctor at least once every six months in 1996. However, about half to two thirds of all infected adults (an estimated 650,000 to 900,000) do not receive regular medical care. These individuals were mainly in the early stages of the disease. Fifty-nine percent of patients met the Centers for Disease Control case definition of AIDS disease, the most advanced stage of HIV infection.

Care settings. Seventy percent of patients treated by doctors in clinics and community hospitals and clinics, and the remaining 30 percent received attention from major teaching hospitals.

Costs

The cost of treating patients in the reference population was about 5.1 billion U.S. dollars annually. This figure is based on data from the first two months of 1996. The authors extrapolated from this figure to estimate the total cost of HIV-infected adults receiving medical care at least once every six months in 1996 was approximately $ 6.7 billion (approximately $ 20,000 per patient), or less than 1 percent of all personal health care expenditures directly in the United States. That number is "not excessive", according to the study, taking into account that the accounts of HIV infection by about 7 percent of total potential years of life lost in the United States.

The most expensive component was hospital care, but the costs of pharmaceuticals increased dramatically during the course of the study period and were more than double the amount spent on ambulatory care (see ...