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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).