Andrulis D P, Weslowski V B, Hintz E, Spolarich A W
Hospital Institute, Washington, DC 20005.
JAMA. 1992 May 13;267(18):2482-6.
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."
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.
Five hundred eighteen of 1158 hospitals surveyed responded to the AIDS and other HIV portions of the survey.
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.
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.
比较获得性免疫缺陷综合征（AIDS，由疾病控制中心定义）患者与患有“其他人类免疫缺陷病毒（HIV）相关疾病”患者的住院治疗利用情况和费用情况。
对代表公立、教学、儿童、社区和天主教医院的五个全国性组织的成员进行邮寄调查。该调查要求提供有关艾滋病和其他HIV患者的人口统计学、服务利用情况、费用及护理资金方面的信息。使用配对t检验进行统计分析，以评估艾滋病患者和其他HIV患者组均值之间的差异。通过计算比例评估分类变量之间的差异，并使用卡方检验进行比较。
1158家接受调查的医院中有518家对调查中的艾滋病和其他HIV部分做出了回应。
325家医院报告至少治疗过一名其他HIV患者。这325家医院治疗了估计在1988年存活的所有艾滋病患者的30%（16213例），并为超过11000名其他HIV患者提供了护理。发现其他HIV患者的服务利用占HIV总负担和相关费用的很大一部分，占所有HIV相关住院病例的35%、所有住院费用的29%以及所有住院损失的35%。人口统计学和接触方式分析表明，其他HIV患者比艾滋病患者更有可能是静脉吸毒者、女性、非白人，并且没有公共或私人医疗保健覆盖来源。
我们的结果表明，仅考虑疾病控制中心定义的艾滋病患者的服务利用情况将大大低估HIV流行对医院造成的总负担。结果表明，疾病控制中心提议的扩大定义将纳入大量住院的HIV人群。
