Updated estimates of healthcare utilization and costs among perinatally HIV-infected children.
OBJECTIVE
This study examined changes in healthcare use among perinatally HIV-infected children and developed new estimates of expected lifetime treatment costs.


METHODS
The study analyzed longitudinal medical record data from the Pediatric Spectrum of Disease study on perinatally HIV-infected children enrolled in 6 US sites during 1995 and 2001 for enrollee characteristics including healthcare utilization. For the year 2001, costs were assigned to hospitalization, HIV-related drug usage, and laboratory testing. To estimate lifetime treatment costs based on those categories, median survival times of 9, 15, and 25 years were assumed and average annual healthcare utilization costs were applied to each year of survival.


RESULTS
From 1995 to 2001, hospitalization rates fell from 0.67 per child-year to 0.23 per child-year (P < 0.05). In 2001, the average cost of healthcare utilization per child was $12,663, including $2164 for hospitalization, $9505 for HIV-related drugs, and $994 for laboratory tests. The discounted lifetime treatment cost, based on those 3 cost categories, was $113,476 for 9 years of survival, $151,849 for 15 years, and $228,155 for 25 years.


CONCLUSIONS
Hospitalizations among perinatally HIV-infected children decreased significantly from 1995 to 2001. Compared with previously published estimates, lifetime treatment costs for children perinatally infected with HIV have remained relatively stable. However, as years of survival increase for this population, lifetime costs also are likely to increase.
Sansom
Stephanie L
SL
Epidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. ssansom@cdc.gov
Anderson
John E
JE
Farnham
Paul G
PG
Dominguez
Kenneth
K
Soorapanth
Sada
S
Clark
Jill
J
Sukalac
Thom
T
Earp
Mary Jo
MJ
Bohannon
Beverly
B
Fowler
Mary Glenn
MG
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D016527:Drug Costs; D015658:HIV Infections / Q000191:economics* / Q000635:transmission; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000191:economics*; D014481:United States