Background: The cost for HIV/AIDS care is important for decision-making, yet costs are typically reported using reimbursements or charges. Methods: We measured medical and support service costs for 1 year of HIV/AIDS care from the provider perspective. All patients receiving care at a specialized outpatient center offering comprehensive services were stratified into 4 groups by CD4 (X 106/ml); 70 were randomly selected from each group for a total of 280. Groups I-IV had CD4 of 0-50, 51-200, 201-500, >500, respectively. Unit costs were calculated including all facility costs (labor, capital, utilities, supplies) using standard micro-costing techniques. All inpatient and outpatient services abstracted from the medical record were multiplied by the unit cost of each, to determine total cost for each patient. Results: The mean total cost for 1 year of care was $21,367 for the study cohort. The mean costs for Groups I-IV were $31,519, $19,534, $19,416, and $14,990, respectively. The percentages of total cost were: Inpatient: 32%, outpatient: 25%, and medications: 43%. The greatest variability in cost by CD4 group was due to inpatient costs, which ranged from $2501-$16,600. Only 29% of patients were hospitalized. Using the proportion of all CORE Center patients in each Group, we estimated it cost $55.5 million to care for our 2801 patients in 1999, or $19,815 per patient. Conclusions: It is important to understand HIV/AIDS medical costs from a provider perspective. Using service utilization and unit costs, our methods permit estimation of actual costs for facilities with different services and severity mix.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Describe the procedures used to measure costs of medical and social support services for HIV/AIDS patients. 2. Discuss the relative cost of medicines, inpatient, and outpatient care for patients with HIV/AIDS at different stages of disease.
Keywords: Economic Analysis, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.