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M94A1822.TXT
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1994-10-24
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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).