Rate of hospitalization and inpatient care costs for HIV-1-infected patients in Pune, India.
BACKGROUND
The transition of human immunodeficiency virus (HIV) infection to acquired immune deficiency syndrome (AIDS) has begun in India, and an increase in AIDS-related hospitalizations and deaths is an anticipated challenge. We estimated the rates of hospitalization and inpatient care costs for HIV-1-infected patients.


METHODS
Data were analysed on 381 HIV-1-infected persons enrolled in a HIV-1 discordant couples' cohort between September 2002 and March 2004. Inpatient care costs were extracted from select hospitals where the study patients were hospitalized and the average cost per hospitalization was calculated.


RESULTS
A majority of the patients were in an advanced state of HIV-1 disease with the median CD4 counts being 207 cells/cmm (range: 4-1131 cells/cmm). In all, 63 participants who did not receive antiretroviral therapy required hospitalization, 53 due to HIV-1-related illnesses and the remaining 10 due to worsening of pre-existing conditions. The overall HIV-1-related hospitalization rate was 34.2 per 100 person-years (95% CI: 26.94-42.93). The median duration of HIV-1-related hospitalization was 10 days (range 2-48 days) and the median cost was Rs 17,464 (range: Rs 400-63,891).


CONCLUSIONS
It is necessary to strengthen the inpatient care infrastructure and supporting diagnostic set-up, and work out economically optimized treatment algorithms for HIV-1-infected patients. Although this analysis does not cover all costs and may not be generalizable, these baseline data might be a useful reference while planning related studies accompanying the government-sponsored programme to roll out antiretroviral therapy to AIDS patients.
Ghate
M V
MV
National AIDS Research Institute, MIDC, Pune, Maharashtra, India. mghate@nariindia.org
Tripathy
S P
SP
Kumar
B Kishore
BK
Godbole
S V
SV
Chittake
A
A
Nyayanirgune
P
P
Gangakhedkar
R R
RR
Divekar
A D
AD
Thakar
M R
MR
Risbud
A R
AR
Bollinger
R C
RC
Mehendale
S M
SM
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics* / Q000209:etiology; D000328:Adult; D000465:Algorithms; D018450:Disease Progression; D017050:Episode of Care; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000191:economics*; D015497:HIV-1; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies