Comparative costs of inpatient care for HIV-infected and uninfected children and adults in Soweto, South Africa.
BACKGROUND
HIV/AIDS creates a massive burden of care for health systems. A better understanding of the impact of HIV infection on health care utilization and costs may enable better use of limited resources.


METHODS
We compared public sector inpatient costs of HIV-infected versus uninfected adults and children at a large hospital in Soweto, South Africa. Daily hotel costs estimated from hospital financial data and total patient visits were combined with utilization, abstracted from patients' charts, and costed using government price lists to estimate total inpatient costs.


RESULTS
A total of 1185 eligible records were included over a 6-week period in 2005. Eight hundred twelve were from HIV-infected patients, and of these, 77 were on antiretroviral (ARV) therapy. The mean length of stay (LOS) and mean drug and intravenous fluid utilization of HIV-infected adults not on ARVs was greater than those of uninfected adults, resulting in a $200 higher total average admission cost. Patients on ARVs had longer LOS and incurred a total average admission cost of $750 more than HIV-infected adults not on ARVs.


CONCLUSIONS
Inpatient costs were greater for this selected group of HIV-infected adults, and even higher for the small proportion of individuals receiving ARVs. Budget allocations should incorporate case mix by HIV and ARV status as a key determinant of hospital expenditure.
Thomas
Leena S
LS
School of Public Health, University of the Witwatersrand, and Gauteng Department of Health, Johannesburg, South Africa.
Manning
Arthur
A
Holmes
Charles B
CB
Naidoo
Shan
S
van der Linde
Frans
F
Gray
Glenda E
GE
Martinson
Neil A
NA
D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D002648:Child; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000191:economics; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D012016:Reference Values; D013019:South Africa