title: Pediatric AIDS at Mount Sinai Medical Center 1988-89: a study of costs and social severity.
abstract: Pediatric AIDS is a continuing problem because of maternal transmission. Medical management is often complicated by the loss of one or both parents and adverse home environments. This study explores the cost of inpatient and clinic care of children admitted with AIDS in 1988 or 1989 at Mount Sinai Medical Center in New York City, and also examines the social severity of the cases. Blue Shield allowances were used to price clinic visits and tests, and prices in a drug trade publication were used to determine medication costs. Inpatient costs calculated per person-month at risk amounted to $48,000 per year. Costs per person-month of the clinic care averaged $461 (38% of which was for drugs), annualized to around $5,500. These costs are higher than those shown by previous studies. A few cases requiring intensive inpatient services accounted for a large percentage of costs. The social severity analysis, based on the family environment at first admission and later, revealed that households were often stressed by chronic illnesses, drug abuse, marital problems and poor residential quality. Given the circumstances in which pediatric AIDS develops, the activities of social workers to strengthen families are essential to facilitating compliance, maintaining health and minimizing use of the hospital.
authors.affiliation: Department of Community Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
authors.forename: C
authors.initials: C
authors.lastname: Muller
authors.forename: M C
authors.initials: MC
authors.lastname: Fahs
authors.forename: G
authors.initials: G
authors.lastname: Mulak
authors.forename: V
authors.initials: V
authors.lastname: Walther
authors.forename: S
authors.initials: S
authors.lastname: Blumenfield
authors.forename: G
authors.initials: G
authors.lastname: Fulop
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000191:economics* / Q000523:psychology; D002648:Child; D002673:Child, Hospitalized / Q000193:education / Q000523:psychology; D017281:Cost of Illness; D005190:Family / Q000523:psychology; D017048:Health Care Costs; D006801:Humans; D009519:New York City; D012189:Retrospective Studies; D012944:Social Support