Department of Public Policy UCLA School of Public Affairs, Los Angeles, CA 90095-1656, USA.
J Acquir Immune Defic Syndr. 2011 Sep 1;58(1):e11-6. doi: 10.1097/QAI.0b013e31822101c8.
To determine the amount of public financing for HIV/AIDS in California and its distribution among treatment, prevention, and support services. To determine the geographical distribution of public financing for HIV/AIDS within California.
Data on HIV/AIDS expenditures were compiled across federal and state agencies supporting HIV/AIDS in fiscal year 2008.
Federal and state data on programs that finance HIV/AIDS treatment, prevention, and support services, including the Ryan White Program, the Centers for Disease Control and Prevention, and the California General Fund, were compiled. California-specific expenditures for Medicare and Medicaid were calculated from claims data. Other entitlement program spending was estimated from national HIV/AIDS data. Data on AIDS cases by county were obtained from the California State Office of AIDS. Mapping to California counties was accomplished with Arc-GIS software.
Public funders accounted for approximately $1.92 billion in HIV/AIDS services in California in fiscal year 2008. Most (90.4%) supported treatment; prevention accounted for 6.4% and support services for 2.6%. The majority of treatment financing came from 2 Federal health entitlement programs, Medicare (36%), and Medicaid (28%). Counties with the highest case loads had lower expenditures per case, suggesting economies of scale.
Treatment expenditures overshadow prevention spending. The dominance of entitlement programs in funding for HIV/AIDS treatment challenges policy makers to monitor the extent and quality of HIV/AIDS care in California. A unified health information system for HIV/AIDS that bridged the fragmented health payment system's data silos would benefit policy makers' efforts to monitor the delivery of HIV/AIDS services.
确定加利福尼亚州用于艾滋病毒/艾滋病的公共资金数额及其在治疗、预防和支持服务方面的分配情况。确定加利福尼亚州内艾滋病毒/艾滋病公共资金的地理分布情况。
汇编了 2008 财政年度支持艾滋病毒/艾滋病的联邦和州机构的艾滋病毒/艾滋病支出数据。
汇编了为艾滋病毒/艾滋病治疗、预防和支持服务提供资金的联邦和州数据，包括“瑞安·怀特计划”、疾病预防控制中心和加利福尼亚普通基金。从医疗保险和医疗补助的索赔数据中计算了加利福尼亚州的具体支出。其他应享权利方案支出是根据国家艾滋病毒/艾滋病数据估计的。从加利福尼亚州艾滋病办公室获得了按县分列的艾滋病病例数据。使用 Arc-GIS 软件实现了对加利福尼亚县的映射。
公共供资者在 2008 财政年度为加利福尼亚州的艾滋病毒/艾滋病服务提供了约 19.2 亿美元资金。其中，大部分（90.4%）用于治疗；预防占 6.4%，支持服务占 2.6%。治疗资金的大部分来自 2 个联邦健康应享权利方案，即医疗保险（36%）和医疗补助（28%）。病例负担最高的县每例病例的支出较低，表明存在规模经济。
治疗支出超过了预防支出。在艾滋病毒/艾滋病治疗供资方面，应享权利方案占主导地位，这给政策制定者带来了挑战，要求其监测加利福尼亚州艾滋病毒/艾滋病护理的范围和质量。一个统一的艾滋病毒/艾滋病卫生信息系统可以弥合支离破碎的卫生支付系统数据孤岛，这将有利于政策制定者监测艾滋病毒/艾滋病服务的提供情况。
