Comparisons of hospital care for patients with AIDS and other HIV-related conditions

Abstract

Objective: To compare utilization and financing of inpatient care for persons with the acquired immunodeficiency syndrome (AIDS) (as defined by the Centers for Disease Control) and those with "other HIV [human immunodeficiency virus]-related illness."

Design: A mailed survey of the members of five national organizations representing public, teaching, children's, community, and Catholic hospitals. The survey requested information on demographics, service utilization, costs, and financing of care for AIDS and other HIV patients. Statistical analysis using paired t tests was conducted to evaluate differences between group means for AIDS and other HIV patients. Differences among categorical variables were evaluated by calculation of proportions and compared using chi 2 tests.

Participants: Five hundred eighteen of 1158 hospitals surveyed responded to the AIDS and other HIV portions of the survey.

Results: Three hundred twenty-five hospitals reported treating at least one other HIV patient. These 325 hospitals treated 30% of all AIDS patients (16,213) estimated to have been alive during 1988, and provided care to over 11,000 other HIV patients. Service utilization by other HIV patients was found to comprise a substantial portion of the total HIV burden and related costs, representing 35% of all HIV-related admissions, 29% of all inpatient costs, and 35% of all inpatient losses. Demographic and mode of exposure analysis indicated that other HIV patients were more likely than AIDS patients to be intravenous drug users, female, nonwhite, and to have no source of public or private coverage for their health care.

Conclusions: Our results demonstrate that accounting for only the utilization of services by persons with AIDS as defined by the Centers for Disease Control will understate significantly the total burden of the HIV epidemic on hospitals. The results suggest that the expanded definition proposed by the Centers for Disease Control would incorporate a large hospitalized HIV population.