title: Differences in the use of health resources by Spanish and immigrant HIV-infected patients.
abstract: BACKGROUND
  HIV-immigrant use of health services and related cost has hardly been analysed. We compared resource utilisation patterns and direct health care costs between Spanish and immigrant HIV-infected patients.
  
  
  METHODS
  All HIV-infected adult patients treated during the years 2003-2005 (372 patients) in this hospital were included. We evaluated the number of out-patient, Emergency Room (ER) and Day-care Unit visits, and number and length of admissions. Direct costs were analysed. We compared all variables between immigrant and Spanish patients.
  
  
  RESULTS
  Immigrants represented 12% (n=43) of the cohort. There were no differences in the number of out-patient, ER, and day-care hospital visits per patient between both groups. The number of hospital admissions per patient for any cause was higher in immigrant than in Spanish patients, 1.3 (4.4) versus 0.9 (2.7), P=.034. A high proportion of visits, both for the immigrant (45.1%) and Spanish patients (43.0%), took place in services other than Infectious Diseases. Mean unitary cost per patient per admission, out-patient visits and ER visits were similar between groups. Pharmacy costs per year was higher in Spanish patients than in immigrants (7351.8 versus 7153.9 euros [year 2005], P=.012). There were no differences in the total cost per patient per year between both groups. The global distribution of cost was very similar between both groups; almost 75% of the total cost was attributed to pharmacy in both groups.
  
  
  CONCLUSIONS
  There are no significant differences in health resource utilisation and associated costs between immigrant and Spanish HIV patients.
authors.affiliation: Infectious Diseases Section, Internal Medicine, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain. mvelasco@fhalcorcon.es
authors.forename: María
authors.initials: M
authors.lastname: Velasco
authors.forename: Virgilio
authors.initials: V
authors.lastname: Castilla
authors.forename: Carlos
authors.initials: C
authors.lastname: Guijarro
authors.forename: Leonor
authors.initials: L
authors.lastname: Moreno
authors.forename: Raquel
authors.initials: R
authors.lastname: Barba
authors.forename: Juan E
authors.initials: JE
authors.lastname: Losa
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000191:economics / Q000208:ethnology; D000328:Adult; D000349:Africa / Q000208:ethnology; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000191:economics; D003365:Costs and Cost Analysis; D016527:Drug Costs / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005060:Europe / Q000208:ethnology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics* / Q000208:ethnology; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006748:Hospital Departments / Q000191:economics / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006786:Hospitals, Urban; D006801:Humans; D007843:Latin America / Q000208:ethnology; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D010607:Pharmacy Service, Hospital / Q000191:economics; D013030:Spain
chemical_list: D019380:Anti-HIV Agents