Medical and non-medical expenses for treating babies born to HIV-infected and non-HIV-infected mothers.
BACKGROUND
Most human immunodeficiency virus (HIV) infections among children under 5 years are transmitted perinatally. These children require more medical attention and hospitalization than non HIV-infected children. The expenses of HIV-infected children are mostly related to opportunistic infections.


OBJECTIVE
To compare the medical and non-medical expenses of treating babies born to HIV-infected and non-HIV-infected mothers at the Queen Sirikit National Institute of Child Health (QSNICH).


METHODS
Consecutive children of HIV-infected and non HIV-infected mothers born at Rajavithi Hospital, Bangkok, were recruited from 1993 to 1995. All of them were followed at QSNICH for free medical services. The demographic and pregnancy data of mothers and the characteristics of the babies of the two groups were compared as well as the number of the hospital visits and reported medical and non-medical expenses.


RESULTS
58 children of HIV-infected mothers and 119 children of non-HIV-infected mother were recruited during this period. Only 30 (51.7%) children of HIV-infected mothers could complete the 18-month requirement, while 90 (75.6%) of the babies born to non-HIV-infected mothers finished the 18 months follow-up period. The two groups did not differ much in terms of demographic characteristics, except that the infant fathers were younger and serology for syphilis was higher in the HIV-infected mothers. This indicated that the HIV-infected mothers had earlier sexual activity. Babies born to the HIV-infected mothers tended to have a lower birth weight and were small for gestational age (SGA). Nine out of 30 babies (30%) born to the HIV-infected mothers were found to be HIV positive at the 18th month of follow-up. The mean medical, non-medical, and total expenses of the babies of the infected group were 2,525.90 +/- 4,328.75, 1,323.07 +/- 1,452.41, 3,848.97 +/- 5,308.90 baht respectively, or were 2.4, 2.0, and 2.2 times those of the non-infected group. These expenses did not include antiretroviral therapy.


CONCLUSIONS
The total medical and non-medical expenses excluding antiretroviral therapy of the children of the infected group were 2.2 times those of the non-infected group. Under the limitation of financial resource and fast growing health care expenditures, the preventive measure for HIV infections including public information, education, communication, and condom promotion should be emphasized.
Pansatiankul
Boonchian
B
Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand.
Bunnag
Thanyanat
T
Leowsrisook
Pimsiri
P
D000328:Adult; D016009:Chi-Square Distribution; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D013785:Thailand