Document 1822
 DOCN  M94A1822
 TI    Medical care costs of HIV-1 infected patients with CD4 < or = 50.
 DT    9412
 AU    von Overbeck J; Schraner C; Schoep M; Furrer H; Jaeger P; Medical
       Policlinic, University Hospital Berne, Switzerland.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):443 (abstract no. PD0379). Unique
       Identifier : AIDSLINE ICA10/94370753
 AB    OBJECTIVE: to estimate medical care costs of HIV-1 infected patients
       with CD4 cell counts < or = 50/microliters in Switzerland. METHODS: 100
       consecutive patients having reached a CD4 cell count < or =
       50/microliters between 1986-1993 were studied. The official price-list
       for out-patients used in the canton Berne and a fixed rate of US$ 521
       per day (estimated for 1992 at our hospital) for in-patients were
       applied to these calculations. RESULTS: There were 86 men and 14 women
       aged 34.5 +/- 8.7 y (mean +/- SD) with median CD4 cell count of
       27/microliters (range 4-50). 88 had AIDS according to CDC criteria.
       Total ambulatory follow-up was 120 person-years (p-y) and total
       hospitalisation follow-up was 13 p-y. Mean follow-up per patient was
       1.33 p-y (-+/ 0.82 SD). 3037 ambulatory consultations were registered.
       Patients were seen 2.14 +/- 1.31 times per month. Total costs were
       calculated at US$ 3.29 million: 21% for ambulatory care and 79% for
       hospital care. Of the hospital care 28% were due to nursing only. The
       median costs for one p-y as out-patient was US$ 20734 (1452-177669) and
       broke down as follows: MD's consultations 17%, laboratory 15%, radiology
       3% and pharmacy 65%. The laboratory comprised hematology 39%, immunology
       22%, microbiology 22% and biochemistry 17%. Radiology comprised
       computerized tomography 37%, sonography 8% and chest x-ray 55%. Costs
       for pharmacy were mainly due to anti-retroviral 46% (82 pat),
       cytomegaloviral 43% (7 pat) and PcP 11% (43 pat) medication.
       CONCLUSIONS: Ambulatory care is also very cost-effective (21% of costs
       for 90% of total follow-up) at this late stage of disease. 65% of
       ambulatory costs are due to pharmacy. New ways for obviating in-patient
       care must be developed and medicament cost-benefit profil must be
       considered.
 DE    Adult  Ambulatory Care/ECONOMICS  Female  *Health Care Costs
       Hospitalization/ECONOMICS  Human  HIV Infections/*ECONOMICS/IMMUNOLOGY
       *HIV-1  *Leukocyte Count  Male  Switzerland  *T4 Lymphocytes  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).