Document 0852
 DOCN  M9470852
 TI    The $147,000 misunderstanding: repercussions of overestimating the cost
       of AIDS.
 DT    9409
 AU    Green J; Oppenheimer GM; Wintfeld N; New York University Medical Center.
 SO    J Health Polit Policy Law. 1994 Spring;19(1):69-90. Unique Identifier :
       AIDSLINE MED/94284552
 AB    The increasing incidence of AIDS in the 1980s prompted inquiry into the
       resources required to meet projected needs. In the first economic study
       to appear on the illness, the Centers for Disease Control (CDC)
       estimated that the costs of inpatient care were $147,000 per AIDS
       patient, heightening concern that the health care system would be
       overwhelmed by the epidemic. However, every study published subsequently
       has produced much lower cost estimates. As a result, many have concluded
       that treatment costs declined due to improved delivery of AIDS care. We
       offer an alternative interpretation, based on evidence demonstrating
       that the CDC's methods and assumptions yielded a figure about three
       times too high. The CDC's erroneous estimate had significant policy
       repercussions. Using the $147,000 figure, the health insurance industry
       lobbied successfully for the right to screen applicants for HIV. Next,
       when a study of San Francisco AIDS patients found local hospital costs
       per case to be $27,571, many concluded that billions of dollars could be
       saved if the San Francisco model of care (emphasizing home and
       community-based services and case management) were universalized. Since
       then, most programs for AIDS services have provided funds for community
       care. While such programs improve access to vital services, they are
       unlikely to guarantee better care for less money. A more informed
       understanding of the cost of AIDS should lead to programs that also
       strengthen inpatient care.
 DE    Acquired Immunodeficiency Syndrome/*ECONOMICS  AIDS Serodiagnosis
       Centers for Disease Control and Prevention (U.S.)  Community Health
       Services/ECONOMICS  *Cost of Illness  Cost Savings  Forecasting  *Health
       Care Costs  Health Policy  Home Care Services/ECONOMICS  Hospital
       Charges  Hospitalization/ECONOMICS  Human  Insurance, Health/ECONOMICS
       Insurance, Life/ECONOMICS  Length of Stay/ECONOMICS  New York City
       Patient Readmission/ECONOMICS  Policy Making  Public Policy  San
       Francisco  Social Sciences  Survival Rate  United States  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).