The usage and costs of health services for HIV infection in Australia

S. F. Hurley, J. M. Kaldor, J. B. Carlin, S. Gardiner, D. B. Evans, P. Chondros, J. Hoy, D. Spelman, W. J. Spicer, H. Wraight, P. Meese

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Abstract

Objective: To describe patterns of health-service usage and the resulting costs in 1992-1993 for Australian men. Design: A prospective survey, stratified by phase of illness. Setting: Hospital and community-based care. Patients: A total of 128 homosexual men: 20 in phase 1 (CD4+ count ≥ 500 x 106/l), 31 in phase 2 (CD4+ count < 500 and ≥ 200 x 106/l), 30 in phase 3 (CD4+ count < 200 x 106/l), and 47 in phase 4 (AIDS). Main outcome measures: Mean monthly service usage rates and costs. Results: Health-service utilization increased and became more hospital-based as illness worsened; the main exception was use of antiretroviral drugs, which peaked in phases 2 and 3. Hospital admission was rare before diagnosis of AIDS. Hospital bed-days per patient per month averaged 3.3 for AIDS patients until the final 3 months of life increasing to 15.8 in the 3 months before death. Mean monthly costs (in 1992-1993 Australian dollars) were $331 [95% confidence interval (CI), 218-455] in phase 1, $677 (95% CI, 540-836) in phase 2, $1372 (95% CI, 1044-1776) in phase 3, and $4615 (95% CI, 3456-5985) for AIDS patients until the last 3 months of life and $13,308 (95% CI, 10,538-16,516) in the 3 months before death. Drugs comprised 57% of total costs in phase 1, but only 30% of costs for patients with AIDS, whereas hospital bed-days comprised 10% of phase 1 costs and 60% of AIDS costs. Conclusions: Health-care utilization and resulting costs increased with severity of illness, and were particularly high for AIDS patients in the 3 months before death. Service-utilization patterns and components of costs varied between each phase.

Original languageEnglish
Pages (from-to)777-785
Number of pages9
JournalAIDS
Volume9
Issue number7
Publication statusPublished - 1 Jan 1995

Keywords

  • AIDS
  • Cost analysis
  • Costs
  • Drugs
  • Health-service utilization
  • HIV infection
  • Inpatient and outpatient episodes
  • Investigations

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