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Fred J. Hellinger, PhD

JAMA. 1993;270(4):474-478.

Abstract
Objective.
—To estimate the cost (total charges for services) of medical care for persons with human immunodeficiency virus (HIV) from the time of infection until death.

Design and Setting.
—Data from the AIDS (acquired immunodeficiency syndrome) Cost and Service Utilization Survey were used.

Patients.
—Data from interviews conducted during the spring and early summer of 1992 with 1164 respondents with HIV were analyzed. The respondents were recruited at 26 sites (hospitals, clinics, and physicians' offices) in 10 cities. Billing data from a survey of providers also were used.

Outcome Measures.
—Estimates of the mean occupancy time in each of four disease stages were obtained from the San Francisco Men's Health Study. These estimates were multiplied by the monthly cost in each stage and summed to derive a synthetic estimate of the lifetime medical care costs of treating a person with HIV.

Results.
—It is estimated herein that the lifetime cost of treating a person with HIV from the time of infection until death is approximately $119 000. The estimated cost of care from HIV infection until the development of AIDS is $50 000, while the estimated cost from AIDS development until death is approximately $69 000. These estimates define upper bounds because they assume persons receive treatment continuously from the moment of infection until death.

Conclusions.
—This study found that the cost of treating a person with AIDS, which has risen rapidly in the past, has fallen as a result of a reduction in the use of inpatient hospital services.

(JAMA. 1993;270:474-478)

Author Affiliations
From the Division of Cost and Financing, Center for General Health Services Extramural Research, Agency for Health Care Policy and Research, US Public Health Service, Rockville, Md.

Footnotes
Reprint requests to Division of Cost and Financing, Center for General Health Services Extramural Research, Agency for Health Care Policy and Research, US Public Health Service, 2101 E Jefferson St, Suite 502, Rockville, MD 20852 (Dr Hellinger).

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