Document 0781
 DOCN  M9610781
 TI    The usage and costs of health services for HIV infection in Australia.
 DT    9601
 AU    Hurley SF; Kaldor JM; Carlin JB; Gardiner S; Evans DB; Chondros P; Hoy
       J; Spelman D; Spicer WJ; Wraight H; et al; Department of Public Health
       and Community Medicine, University of; Melbourne, Victoria, Australia.
 SO    AIDS. 1995 Jul;9(7):777-85. Unique Identifier : AIDSLINE MED/96035242
 AB    OBJECTIVE: To describe patterns of health-service usage and the
       resulting costs in 1992-1993 for Australian men. DESIGN: A prospective
       survey, stratified by phase of illness. SETTING: Hospital and
       community-based care. PATIENTS: A total of 128 homosexual men: 20 in
       phase 1 (CD4+ count > or = 500 x 10(6)/l), 31 in phase 2 (CD4+ count <
       500 and > or = 200 x 10(6)/l), 30 in phase 3 (CD4+ count < 200 x
       10(6)/l), and 47 in phase 4 (AIDS). MAIN OUTCOME MEASURES: Mean monthly
       service usage rates and costs. RESULTS: Health-service utilization
       increased and became more hospital-based as illness worsened; the main
       exception was use of antiretroviral drugs, which peaked in phases 2 and
       3. Hospital admission was rare before diagnosis of AIDS. Hospital
       bed-days per patient per month averaged 3.3 for AIDS patients until the
       final 3 months of life increasing to 15.8 in the 3 months before death.
       Mean monthly costs (in 1992-1993 Australian dollars) were $331 [95%
       confidence interval (CI), 218-455] in phase 1, $667 (95% CI, 540-836) in
       phase 2, $1372 (95% CI, 1044-1776) in phase 3, and $4615 (95% CI,
       3456-5985) for AIDS patients until the last 3 months of life and $13,308
       (95% CI, 10,538-16,516) in the 3 months before death. Drugs comprised
       57% of total costs in phase 1, but only 30% of costs for patients with
       AIDS, whereas hospital bed-days comprised 10% of phase 1 costs and 60%
       of AIDS costs. CONCLUSIONS: Health-care utilization and resulting costs
       increased with severity of illness, and were particularly high for AIDS
       patients in the 3 months before death. Service-utilization patterns and
       components of costs varied between each phase.
 DE    Acquired Immunodeficiency Syndrome/*ECONOMICS/EPIDEMIOLOGY
       Australia/EPIDEMIOLOGY  Community Health Services/ECONOMICS/*UTILIZATION
       *Health Care Costs  Homosexuality, Male  Human  Male  Support, Non-U.S.
       Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).