HIV Cost Research Articles

Managed-care HIV costs levelling out

Managed-care HIV costs levelling out

Managed-care HIV costs levelling out

Managed-care HIV costs levelling out

Costs of HIV+/AIDS at CD4+ counts disease stages based on treatment protocols.

We report treatment protocols for HIV+/AIDS patients by CD4+ counts (T-lymphocyte cells/mm3: > or = 500, 499-200, 199-50, and < 50) as a tool to provide better definition and to project annual costs (total charges for services) and lifetimes costs for HIV+/AIDS. The treatment protocols, derived from the literature and an HIV+/AIDS Physician Panel, defined the resource use associated with antiretroviral therapy and opportunistic disease prophylaxis and treatment. Resource use costs were derived from the published literature, insurance database, Medicare fee schedules, surveys, and the Physician Panel. At CD4+ counts, the rates of opportunistic diseases were derived from the Physician Panel experience; the mean occupancy times were derived from the literature. The sensitivity analysis indicated stability of the lifetime costs to variation in mean occupancy times, rates of opportunistic diseases, rates of adverse events (AE), and costs. The total annual costs (1995 dollars) of HIV+/AIDS patients ranged from $1,934 (> or = 500), $6,015 (200-499), and $9,031 (50-199), to $25,239 ( < 50). The annual costs of opportunistic diseases are esophageal candidiasis (EC) ($2,194), tuberculosis (TB) ($2,924), cryptococcal meningitis (CM) ($17,264), toxoplasmosis ($17,631), Mycobacterium avium complex (MAC) (+20,153), Non-Hodgkin's lymphoma (NHL) ($22,329), wasting syndrome ($26,676), central nervous system (CNS) lymphoma ($27,333), Pneumocystis carinii pneumonia (PCP) [mild ($3,545), moderate ($4,889), and severe ($32,609)], Kaposi' sarcoma (KS) [mild/moderate ($5,902), and severe ($10,744)], and cytomegalovirus (CMV) retinitis ($100,337). The projected lifetime costs of HIV+/AIDS are $94,726 (annual costs $7,645). Our lower lifetime costs as compared with recent estimates may be due to including resources only for HIV+/AIDS-related treatment and not for non-HIV+/AIDS conditions, as well as reduced resource use resulting from more efficient diagnostic and therapeutic techniques and earlier prophylaxis provided by experienced HIV+/AIDS physicians. Nonetheless, our estimates are consistent with decreasing costs of HIV+/AIDS due to a reduction in the average length of stay and frequency of hospitalizations as well as to replacement of inpatient care by outpatient services.

Use of Space-Filling Curves in Generating a National Rural Sampling Frame for HIV/AIDS Research∗

The classical geographic research problem of regionalization and resource allocation is most commonly tackled by means of location-allocation methods. This paper introduces the spatial-order method as an alternative for creating regions or clusters. The spatial-order method utilizes space-filling curves, also known as Peano curves, to determine the nearness or spatial order of areal units, such as counties. Given a capacity constraint, the areal units are grouped consecutively according to their spatial order values. We applied the method to create clusters of rural counties for a national sampling survey of HIV/AIDS patients in the United States. Using the criteria that each cluster had approximately 50 new AIDS cases in 1991–1993 and that contiguity of areal units was maximized, 226 clusters were created from the 1,853 rural counties or health districts. The rural clusters generated by this method have been adopted as the national rural sampling frame in the HIV Cost and Services Utilization Study (HCSU...

The social impact of HIV/AIDS in developing countries

This paper highlights some of the main areas of social impact of HIV and AIDS in developing countries and suggests that these must constitute priority areas for action among international and national policy makers, as well as others concerned with HIV and AIDS. The areas of impact which are considered are: economic and demographic; labour productivity; agricultural production and development; pressures on the health sector; the role of families and households; children; women; HIV/AIDS discrimination; and the impact of HIV/AIDS on the individual. Some of the responses which have already been developed to the impact of HIV and AIDS are considered, and many of these are seen to be at least partially effective ways of addressing some of the consequences of pandemic. The paper concludes however that the escalating cost of HIV and AIDS, in personal, social and economic terms, demands a greater degree of considered, concerted and coordinated action by international, national and local agencies.

HIV costs £75,000 for each patient

HIV costs £75,000 for each patient

Prevalence of HIV infection and cost of medical follow-up for asymptomatic seropositive patients followed in general practice in France

To estimate the number of HIV patients followed by general practitioners and the average cost of their medical care, a questionnaire was mailed to 500 general practitioners of the French Communicable Diseases Network (1% sample, representative of French general practitioners). They were asked the number of HIV seropositive patients detected in 1987, the number of HIV positive asymptomatic patients regularly followed, the number of consultations and the type of biological and clinical examinations prescribed. The response rate was 78%. During the past year 29% of practitioners were caring for one or more infected patients. The mean number of HIV seropositive patients known per general practitioner was 1.37 corresponding to an estimated 69 000 ± 3000 cases, (mean ± S.D.) for France. The mean number of HIV seropositive patients diagnosed in 1987 was 0.60 per general practitioner (30 000 ± 2000 cases) and the mean number of HIV seropositive patients followed regularly was 0.89 per general practitioner (45 000 ± 2500 cases). Two-thirds of HIV seropositive patients were regular patients of general practitioners. The mean number of visits per patient was 3.6 per year. Biological examinations regularly prescribed were blood count, CD4/CD8 ratio, lymphocyte counts, thrombocyte counts, HBs antigen detection and HIV antigen detection. Average costs were 523 ± 18 FF for the first visit and 446 ± 36 FF for subsequent examinations. In total, the average cost of general practitioner visits per patient per year have been estimated at 2,288 ± 251 FF (380 ± 42 US$).