Contemporary costs of HIV healthcare in the HAART era
Contemporary costs of HIV healthcare in the HAART era
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DOI：
10.1097/qad.0b013e32833f3c14
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发表时间：
2010-11-13
期刊：
影响因子：
3.8
通讯作者：
Moore, Richard D.
中科院分区：
文献类型：
--
作者：
Gebo, Kelly A.;Fleishman, John A.;Moore, Richard D.
背景：艾滋病毒医疗保健的提供历来是昂贵的。关于艾滋病毒保健费用的最新国家数据是1996-1998年的数据。我们提供艾滋病毒管理支出的最新估计。方法：我们对HIV研究网络中10个站点的医疗记录进行了横断面回顾，HIV研究网络是一个由美国大量HIV护理提供者组成的联盟。我们评估了2006年接受初级艾滋病毒护理的14691名成年艾滋病毒感染者的住院天数、门诊访问量、抗逆转录病毒和机会性疾病预防药物处方。我们根据2006年获得的中位数CD4细胞计数（500个细胞/ μ l）来估计总护理支出。单位护理成本基于住院护理的医疗成本和利用项目（HCUP）数据、药物的折扣平均批发价格和门诊护理的医疗保险医师费用。结果：对所有CD4层进行平均，2006年三个地点的艾滋病毒护理人均年平均总支出为1,912美元，四分位数范围为11,045美元至22,626美元。CD4细胞计数为50个或更少的患者的人均年护理支出最高（40 678美元），CD4细胞计数超过500个细胞/毫升的患者的人均年护理支出最低（16 614美元）。大部分费用可归因于药物，但CD4细胞计数为50细胞/毫升或更少的患者除外，他们的住院费用最高。结论：美国的艾滋病毒医疗保健仍然很昂贵，大部分支出可归因于药物。随着艾滋病毒存活率的提高，治疗费用可能会增加，今后应加以监测。(C) 2010年Wolters Kluwer Health垂直条Lippincott Williams & Wilkins
Background: The delivery of HIV healthcare historically has been expensive. The most recent national data regarding HIV healthcare costs were from 1996-1998. We provide updated estimates of expenditures for HIV management.Methods: We performed a cross-sectional review of medical records at 10 sites in the HIV Research Network, a consortium of high-volume HIV care providers across the United States. We assessed inpatient days, outpatient visits, and prescribed antiretroviral and opportunistic illness prophylaxis medications for 14 691 adult HIV-infected patients in primary HIV care in 2006. We estimated total care expenditures, stratified by the median CD4 cell count obtained in 2006 (500 cells/mu l). Per-unit costs of care were based on Healthcare Cost and Utilization Project (HCUP)data for inpatient care, discounted average wholesale prices for medications, and Medicare physician fees for outpatient care.Results: Averaging over all CD4 strata, the mean annual total expenditures per person for HIV care in 2006 in three sites was US $19 912, with an interquartile range from US $11 045 to 22 626. Average annual per-person expenditures for care were greatest for those with CD4 cell counts 50 cell/mu l or less (US $40 678) and lowest for those with CD4 cell counts more than 500 cells/ml (US $16 614). The majority of costs were attributable to medications, except for those with CD4 cell counts 50 cells/ml or less, for whom inpatient costs were highest.Conclusion: HIV healthcare in the United States continues to be expensive, with the majority of expenditures attributable to medications. With improved HIV survival, costs may increase and should be monitored in the future. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins