       Document 1830
 DOCN  M94A1830
 TI    Ten years of AIDS treatment in a large hospital organisation.
 DT    9412
 AU    Beauiouan L; de Bonnay P; Herson S; Sauvat JF; Vittecoq D; Assistance
       Publique-Hopitaux de Paris, Mission SIDA, France.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):441 (abstract no. PD0374). Unique
       Identifier : AIDSLINE ICA10/94370745
 AB    The Assistance Publique-Hopitaux de Paris (AP-HP) is the university
       hospital structure for the Paris region (12 million inhabitants) and is,
       with 18,000 acute-care beds, the largest hospital organisation in
       Europe. The AP-HP treats one third of all HIV+ patients in France and
       allocated US $148 million to this effort in 1994. OBJECTIVE: This study
       aims to demonstrate how, over the past ten years, the AIDS epidemic has
       forced the AP-HP not only to meet quantitative needs in terms of
       financial, human and technical resources, but, even more importantly, to
       rethink and restructure part of its medical organisation and to change
       procedures and methods of organising and providing hospital care.
       METHODS: A study of the evolution of the numbers and characteristics of
       the patients and, in parallel, of the resources allocated and the
       restructuring done makes it possible, using various indicators (e.g.,
       percent of patients treated in the different specialised structures) to
       illustrate the accommodation of the structures to variations in the
       types of patients treated (asymptomatic patients, AIDS sufferers, drug
       addicts...). RESULTS: The policies implemented have, to a large extent,
       made it possible to meet the requirements of the epidemic and have
       substantially enlarged the scope of clinical research. The number of
       patients increased by an average of 16% annually between 1988 and 1993.
       Whereas in 1988 only 43% of the patients were treated in specialised
       units, the proportion had risen to 80% in 1993. Over 1000 kg of AZT and
       DDI were dispensed in 1993, compared to 504 kg in 1988. DISCUSSION AND
       CONCLUSIONS: Whereas the AIDS epidemic has accelerated structural
       changes that leave no part of the organisation untouched, the AP-HP must
       continue adapting to developments in the epidemic and especially to the
       worsening condition of the PWAs in treatment and to the increasing
       numbers of drug-addicted patients.
 DE    Acquired Immunodeficiency Syndrome/*THERAPY  Hospitals,
       University/ORGANIZATION & ADMIN/*STATISTICS & NUMER  DATA  Human  Paris
       MEETING ABSTRACT

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

