Resource utilization and stage of illness: a study of an outpatient AIDS clinic

Since the early 1990s, the trend in AIDS patient care has been to increase utilization of outpatient services, resulting in less frequent aggressive and lengthy hospital stays. This study retrospectively analyzes financial and sociodemographic data of 240 HIV/AIDS patients in a large, infectious disease program in Atlanta, GA. The results indicated the total cost of care per year for AIDS patients (alive or recently deceased) was $24,108 per year. Approximately 58% of this cost was attributable to inpatient care, 34% to outpatient care, and 8% to physician services. African-American race and IV drug use were negatively related to outpatient costs during the healthiest stage of illness. These demographics gave no prediction to the amount of cost consumed during clinical AIDS. On the other hand, males and patients on Medicaid were positive predictors of inpatient services, while homosexual patients were associated with fewer inpatient services. This study complements other projects, yet some questions remain unanswered. For example, does the seemingly low cost of care negatively impinge upon the overall care of the patient? This and further questions will have to be addressed in future studies.