       Document 0823
 DOCN  M9640823
 TI    Hospital service utilization by HIV/AIDS patients and their management
       cost in a provincial genitourinary medicine department.
 DT    9604
 AU    Nageswaran A; Kinghorn GR; Shen RN; Priestley CJ; Kyi TT; Department of
       Genito-Urinary Medicine, Royal Hallamshire; Hospital, Sheffield, UK.
 SO    Int J STD AIDS. 1995 Sep-Oct;6(5):336-44. Unique Identifier : AIDSLINE
       MED/96122190
 AB    The hospital management of 108 HIV/AIDS patients cared for by the
       genitourinary medicine department, Sheffield, UK between 1984-93 was
       retrospectively studied to quantify the services utilized by these
       patients and to detail the management costs (1993 price) of outpatient
       (OP) services, inpatient (IP) care, investigational services and
       therapeutic provisions. The services utilized and cost are presented
       separately for the different clinical stages of the infection and as per
       patient year. Of the 108 patients, 95 (88%) were males and 13 (12%)
       females; most males (76.8%) acquired the infection through homosexual
       exposure, while 46% of females acquired it heterosexually. The mean
       number of OP consultation per asymptomatic, symptomatic non-AIDS and
       AIDS patient years were 11.6, 16.4 and 32.8 respectively; the mean
       number of IP episodes for each of these clinical groups were 0.15, 0.83
       and 3.88 with IP stays 0.7, 3.5 and 40.6 days per patient year
       respectively. The annual costs of OP care (45.26 pounds per
       consultation), drugs and investigations were, respectively 525 pounds,
       213 pounds and 153 pounds per asymptomatic patient year, 742 pounds,
       2097 pounds and 224 pounds per symptomatic non-AIDS patient year and
       1485 pounds, 2928 pounds and 382 pounds per AIDS patient year. The
       average annual OP drug cost per patient year showed little change since
       1988. However, in the AIDS group, contributions from differing drug
       classes showed significant changes; while the contribution of
       antiretroviral drugs fell from 80.2% of the drug cost per AIDS patient
       year in 1990 to 31.3% in 1993, that from antibiotics rose from 0.3% in
       1990 to 26.4% in 1993 and other antivirals from 9.4% in 1988 to 22.6% in
       1993. These changes were related to lower recommended daily dosage of
       zidovudine and to wider prescription of antibiotics for atypical
       mycobacterial infections and domiciliary gancyclovir for CMV infection.
       The costs of annual mean IP care, IP drugs, IP investigations and IP
       procedures per AIDS patient year were 5926 pounds (146 pounds per IP
       stay), 2983 pounds, 282 pounds and 145 pounds respectively. The overall
       management cost of one AIDS patient year was 14,131 pounds and lifetime
       AIDS management cost, based on a mean survival of 17 months, a little
       more than 20,000 pounds. The annual management cost of an asymptomatic
       and symptomatic non-AIDS patient year is approximately 1/14th and 1/4th
       of the cost of an AIDS patient year.
 DE    Adult  Drug Costs  England  Female  Health Services Research  Hospital
       Costs/*STATISTICS & NUMER DATA/TRENDS  Human  HIV
       Infections/*ECONOMICS/*THERAPY  Male  Referral and
       Consultation/ECONOMICS/TRENDS  Retrospective Studies  Support, Non-U.S.
       Gov't  Urology Department, Hospital/*ECONOMICS/*UTILIZATION  JOURNAL
       ARTICLE

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

