The usage and costs of health services for HIV infection in Australia.
OBJECTIVE
To describe patterns of health-service usage and the resulting costs in 1992-1993 for Australian men.


METHODS
A prospective survey, stratified by phase of illness.


METHODS
Hospital and community-based care.


METHODS
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).


METHODS
Mean monthly service usage rates and costs.


RESULTS
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.


CONCLUSIONS
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.
Hurley
S F
SF
Department of Public Health and Community Medicine, University of Melbourne, Victoria, Australia.
Kaldor
J M
JM
Carlin
J B
JB
Gardiner
S
S
Evans
D B
DB
Chondros
P
P
Hoy
J
J
Spelman
D
D
Spicer
W J
WJ
Wraight
H
H
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics* / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D003153:Community Health Services / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs; D018451:Homosexuality, Male; D006801:Humans; D008297:Male