Hurley S F, Kaldor J M, Carlin J B, Gardiner S, Evans D B, Chondros P, Hoy J, Spelman D, Spicer W J, Wraight H
Department of Public Health and Community Medicine, University of Melbourne, Victoria, Australia.
AIDS. 1995 Jul;9(7):777-85. doi: 10.1097/00002030-199507000-00016.
To describe patterns of health-service usage and the resulting costs in 1992-1993 for Australian men.
A prospective survey, stratified by phase of illness.
Hospital and community-based care.
A total of 128 homosexual men: 20 in phase 1 (CD4+ count > or = 500 x 10(6)/l), 31 in phase 2 (CD4+ count < 500 and > or = 200 x 10(6)/l), 30 in phase 3 (CD4+ count < 200 x 10(6)/l), and 47 in phase 4 (AIDS).
Mean monthly service usage rates and costs.
Health-service utilization increased and became more hospital-based as illness worsened; the main exception was use of antiretroviral drugs, which peaked in phases 2 and 3. Hospital admission was rare before diagnosis of AIDS. Hospital bed-days per patient per month averaged 3.3 for AIDS patients until the final 3 months of life increasing to 15.8 in the 3 months before death. Mean monthly costs (in 1992-1993 Australian dollars) were $331 [95% confidence interval (CI), 218-455] in phase 1, $667 (95% CI, 540-836) in phase 2, $1372 (95% CI, 1044-1776) in phase 3, and $4615 (95% CI, 3456-5985) for AIDS patients until the last 3 months of life and $13,308 (95% CI, 10,538-16,516) in the 3 months before death. Drugs comprised 57% of total costs in phase 1, but only 30% of costs for patients with AIDS, whereas hospital bed-days comprised 10% of phase 1 costs and 60% of AIDS costs.
Health-care utilization and resulting costs increased with severity of illness, and were particularly high for AIDS patients in the 3 months before death. Service-utilization patterns and components of costs varied between each phase.
描述1992 - 1993年澳大利亚男性的卫生服务使用模式及其产生的费用。
一项前瞻性调查，按疾病阶段分层。
医院和社区护理。
总共128名同性恋男性，其中1期（CD4 + 细胞计数≥500×10⁶/l）20人，2期（CD4 + 细胞计数<500且≥200×10⁶/l）31人，3期（CD4 + 细胞计数<200×10⁶/l）30人，4期（艾滋病）47人。
每月平均服务使用率和费用。
随着病情恶化，卫生服务利用率增加且更多地依赖医院服务；主要例外是抗逆转录病毒药物的使用，其在2期和3期达到峰值。在艾滋病诊断之前很少住院。艾滋病患者在生命的最后3个月之前，每月每位患者的住院天数平均为3.3天，在死亡前3个月增加到15.8天。平均每月费用（以1992 - 1993年澳大利亚元计），1期为331美元[95%置信区间（CI），218 - 455]，2期为667美元（95% CI，540 - 836），3期为1372美元（95% CI，1044 - 1776），艾滋病患者在生命的最后3个月之前为4615美元（95% CI，3456 - 5985），在死亡前3个月为13308美元（95% CI，10538 - 16516）。药物在1期占总费用的57%，但在艾滋病患者中仅占费用的30%，而住院天数在1期费用中占10%，在艾滋病费用中占60%。
卫生保健利用率及其产生的费用随疾病严重程度增加而增加，在艾滋病患者死亡前3个月尤为高昂。各阶段的服务使用模式和费用构成各不相同。
