       Document 0931
 DOCN  M9570931
 TI    AIDS scenarios for The Netherlands; the economic impact on hospitals.
 DT    9506
 AU    Postma MJ; Jager JC; Dijkgraaf MG; Borleffs JC; Tolley K; Leidl RM;
       National Institute of Public Health and Environmental Protection,;
       Department of Public Health Forecasting, The Netherlands.
 SO    Health Policy. 1995 Feb;31(2):127-50. Unique Identifier : AIDSLINE
       AHA/95229544
 AB    OBJECTIVE: To assess the economic impact of HIV/AIDS on the health care
       system in The Netherlands. Data and methods: Two types of data are used:
       (i) routine surveillance data on AIDS incidence and (ii) information on
       hospital resource utilisation and corresponding monetary costs.
       Progression of disease is modelled using a multi-stage model, with
       stages corresponding to clinical classifications and to different phases
       of health care need. Economic impact is analysed for all stages in three
       scenarios: the reference and two alternative scenarios. RESULTS: In the
       year 2000 hospital bed need would reach 220 beds if yearly new HIV
       infections in the 1990s remain at the level estimated for the end of the
       1980s, and if the intensity of hospital care remains constant. A minimum
       need of 125 beds is projected if no new HIV infections occur in the
       1990s. Hospital costs in 1993 are estimated to amount to 33.8 million
       ECUs. Scenarios indicate a range of 26.7-50.7 million ECUs for the year
       2000 (price level: 1993). The proportion of the costs of hospital
       inpatient care and cure in total hospital costs increases, whereas the
       proportion for outpatient services decreases. Conclusions: Projected
       hospital bed need of 125-220 for HIV/AIDS in the year 2000 is limited
       compared to the projections for coronary heart disease and stroke, but
       approaches that for lung cancer, pneumonia and diabetes. We estimate
       hospital costs to have been 85% of total health care costs for HIV/AIDS
       in 1993. In 1993, the estimated proportions in hospital costs are 41%
       for inpatient care, 20% for inpatient cure and 39% for outpatient
       facilities. Our scenarios indicate a decreasing share of outpatient
       costs--possibly to 30% of total hospital costs for HIV/AIDS in
       2000--illustrating the growing relative importance of the AIDS stage for
       the hospital costs. We project hospital costs for HIV/AIDS in 2000 to
       reach up to 0.53% of projected hospital costs for all diseases. A
       present value of 38 million ECUs (23%) of hospital costs projected in
       the reference scenario might be avoidable, during the period 1994-2000.
       However, with unchanged treatment patterns a present value of 127
       million ECUs for hospital costs during the same period is projected to
       represent unavoidable costs (discount rate: 5%). In The Netherlands,
       data needs in the field of economic impact assessment of HIV/AIDS
       especially refer to registrations of non-hospital outpatient resource
       utilisation and costs.
 DE    Acquired Immunodeficiency Syndrome/CLASSIFICATION/*ECONOMICS/
       EPIDEMIOLOGY  Decision Making  Disease Progression  Economics,
       Hospital/*TRENDS  Health Care Rationing/ECONOMICS  Health Facility Size
       Health Services Needs and Demand/TRENDS  Hospital Costs/*TRENDS
       Hospitalization/ECONOMICS/STATISTICS & NUMER DATA/TRENDS  Human
       Netherlands/EPIDEMIOLOGY  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).

