Andrulis D P, Weslowski V B, Gage L S
National Public Health and Hospital Institute, Washington, DC 20004.
JAMA. 1989 Aug 11;262(6):784-94.
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.
1987年，国家公共卫生与医院协会对623家急症护理医院进行了一项全国性调查，以获取与获得性免疫缺陷综合征（艾滋病）患者的住院和门诊护理相关的信息。276家医院报告称收治过艾滋病患者；平均住院时间为16.8天。每名住院患者每天的平均费用和收入分别为681美元和545美元，每名患者每年的费用为17,910美元。1987年艾滋病住院护理的估计费用为4.86亿美元；医疗补助是主要支付方。对今年以及1985年至1987年期间的地区和所有制情况进行比较后发现，在利用率、支付方来源和融资方面存在显著差异。结果表明，与支付方来源或缺乏保险相关的报销和损失存在重大差异，许多为大量低收入艾滋病患者提供服务的医院面临中度至重度资金短缺。我们得出结论，大城市中相对较少的医院里艾滋病患者越来越集中，这可能会使获得为治疗提供充分支持所需的更广泛政治基础变得更加困难。
