The effects of intravenous drug use and gender on the cost of hospitalization for patients with AIDS.
At present limited data exist describing the hospital use patterns of intravenous drug users (IVDUs) and women with AIDS. Our objective was to determine if frequency of hospitalization, length of stay (LOS), and cost per hospitalization varied by risk status and gender, controlling for a variety of confounders, including severity of illness as measured by the Turner-Kelly-Ball and Justice AIDS severity of illness systems. We performed a population-based cohort study that compared all women (n = 69) and male IVDUs (n = 74) with AIDS diagnosed in Massachusetts in 1987 with a random sample of all male, nonintravenous drug-using patients diagnosed in that year (n = 148). Frequency of hospitalization, LOS, and cost of hospital care were obtained from hospital billing records for 1987 and 1988. Regression analysis showed 42% longer lengths of stay (p < or = 0.001) and 38% higher cost (p < or = 0.001) per hospitalization for IVDUs with AIDS compared with non-IVDU homosexual AIDS patients. No statistically significant differences by gender were observed. Our results suggest that hospital care for IVDUs is likely to be more expensive. Policymakers should incorporate these data when planning for AIDS care. In addition, instruments to assess severity of illness should incorporate information on intravenous drug use.
Institute for Urban Health Policy, Research and Education, Boston Department of Health and Hospital, MA 02118.
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D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000191:economics*; D000328:Adult; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005260:Female; D015438:Health Behavior; D006716:Homosexuality; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D016013:Likelihood Functions; D008297:Male; D008404:Massachusetts; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000191:economics