Hellinger F J
Division of Cost and Financing, US Public Health Service, Rockville, MD 20852.
JAMA. 1993 Jul 28;270(4):474-8.
To estimate the cost (total charges for services) of medical care for persons with human immunodeficiency virus (HIV) from the time of infection until death.
Data from the AIDS (acquired immunodeficiency syndrome) Cost and Service Utilization Survey were used.
Data from interviews conducted during the spring and early summer of 1992 with 1164 respondents with HIV were analyzed. The respondents were recruited at 26 sites (hospitals, clinics, and physicians' offices) in 10 cities. Billing data from a survey of providers also were used.
Estimates of the mean occupancy time in each of four disease stages were obtained from the San Francisco Men's Health Study. These estimates were multiplied by the monthly cost in each stage and summed to derive a synthetic estimate of the lifetime medical care costs of treating a person with HIV.
It is estimated herein that the lifetime cost of treating a person with HIV from the time of infection until death is approximately $119,000. The estimated cost of care from HIV infection until the development of AIDS is $50,000, while the estimated cost from AIDS development until death is approximately $69,000. These estimates define upper bounds because they assume persons receive treatment continuously from the moment of infection until death.
This study found that the cost of treating a person with AIDS, which has risen rapidly in the past, has fallen as a result of a reduction in the use of inpatient hospital services.
估算感染人类免疫缺陷病毒(HIV)者从感染至死亡期间的医疗费用(服务总收费)。
使用了艾滋病(获得性免疫缺陷综合征)成本与服务利用调查的数据。
分析了1992年春季和初夏对1164名HIV感染者进行访谈的数据。这些受访者是在10个城市的26个地点(医院、诊所和医生办公室)招募的。还使用了对医疗机构调查的计费数据。
从旧金山男性健康研究中获得了四个疾病阶段中每个阶段的平均住院时间估计值。将这些估计值乘以每个阶段的月成本,然后求和得出治疗一名HIV感染者终身医疗费用的综合估计值。
本文估计,治疗一名HIV感染者从感染至死亡的终身成本约为119,000美元。从HIV感染到发展为艾滋病的估计护理成本为50,000美元,而从艾滋病发展到死亡的估计成本约为69,000美元。这些估计值定义了上限,因为它们假设患者从感染时刻起持续接受治疗直至死亡。
本研究发现,过去艾滋病治疗费用迅速上升,由于住院医院服务使用减少,费用有所下降。