The 1987 US hospital AIDS survey

Abstract

In 1987, the National Public Health and Hospital Institute conducted a national survey of 623 acute-care hospitals to obtain information relating to inpatient and outpatient care for persons with acquired immunodeficiency syndrome (AIDS). Two hundred seventy-six hospitals reported treating persons with AIDS; the average length of stay was 16.8 days. Average costs and revenues per inpatient day were $681 and $545, respectively, with a cost per patient per year of $17,910. Estimated cost for AIDS inpatient care during 1987 was $486 million; Medicaid represented the primary payer. Regional and ownership comparisons for this year and between 1985 and 1987 indicated significant differences in utilization, payer source, and financing. Results suggest major differences in reimbursement and losses related to payer source or lack of insurance, with many hospitals that serve large numbers of low-income persons with AIDS encountering moderate to severe financial shortfalls. We conclude that increasing concentrations of persons with AIDS in relatively few hospitals in large cities may make it more difficult to secure the broader political base necessary to obtain adequate support for treatment.

KIE: The National Public Health and Hospital Institute conducted a survey of 623 acute care hospitals to obtain information on inpatient and outpatient care of persons with AIDS (PWAs). This article summarizes and comments upon 1987 data from 322 responding hospitals. Participants answered questions in six categories: general inpatient utilization; demographic and risk-group characteristics; hospital organization and staffing of AIDS treatment programs; outpatient information; financial characteristics of inpatient and outpatient care; and specific treatments available for PWAs. Institutions also were asked to report cost, charge, and revenue per day for non-AIDS patients. The authors conclude that hospital losses due to financial shortfalls and the growing volume of PWA care reinforce the need for policy changes to insure that hospitals, particularly public hospitals, are adequately reimbursed for AIDS care, and to encourage the development of alternatives to inpatient treatment.