艾滋病病毒感染者和艾滋病患者卫生服务利用及医疗费用的研究

目的 了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)患者对卫生服务的利用及直接医疗费用。方法 于1999年12月对北京佑安医院收治的HIV感染者和AIDS患者进行回顾性研究。收集一般人口学特征、HIV感染及疾病进程的相关信息、过去一年内卫生服务利用情况及医疗费用资料。结果 共调查29例HIV感染者，其中17例(58．62％)为无症状期的HIV感染者，12例为AIDS患者。无症状期的HIV感染者平均每人年门诊6次，住院1．23次，每人年住院58．6天；AIDS患者平均每人年门诊7．8次，住院2．1次，住院200．2天。无症状期的HIV感染者平均每人年门诊费用为13729元，住院费用为4745元；AIDS患者平均每人年门诊及住院费用分别为15053元和22242元。既门诊又住院平均每人年的门诊及住院医疗费用，无症状期的HIV感染者为16248元，AIDS患者为36795元。结论 HIV感染者和AIDS患者医疗费用昂贵，对卫生服务的需求量大。需要进一步在更大范围内了解国内HIV感染者和AIDS患者对卫生服务利用的现状及需求。

Study on the utilization of health services and costs of hospital-based medical care for 29 patients with HIV/AIDS in China

Objective To describe the costs of medical care and utilization of health service of patients with HIV/AIDS. Methods Patients with human immunodeficiency virus(HIV)/AIDS treated in the Beijing You'an Hospital were interviewed retrospectively during December 1999. Data on demographic characteristics, disease process, and utilization of health service and costs of hospital-based medical care were collected. Results A total number of 29 patients with HIV/AIDS were interviewed, including 17 ( 58.62 %) asymptomatic HIV infections and 12 AIDS patients. Asymptomatic HIV infections had a mean of 6 outpatient visits, 1.3 hospitalizations and 58.6 inpatient hospital days per person-year. AIDS patients made, on average, 7.8 outpatient visits, 2.1 hospitalizations and 200.2 inpatient hospital days per person-year. The outpatient and inpatient medical costs were 13 729 RMB and 4 745 RMB for asymptomatic HIV infections, and 15 053 RMB and 22 242 RMB for AIDS patients per person-year respectively. For those who took both outpatient and inpatient medical care, the medical care costs, including costs of outpatient care and those of inpatient care, were 16 248 RMB for asymptomatic HIV infections and 36 795 RMB for AIDS patients. Conclusion Demands for health services and costs for medical care were high among patients with HIV/AIDS. Further study on utilization of health services and cost of medical care for patient with HIV/AIDS in a wider geographic coverage are needed.