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AIDS treatment costs during the last months of life: evidence from the ACSUS
F J Hellinger1, J A Fleishman, D C Hsia
1Division of Cost and Financing, CGHSER, Agency for Health Care Policy and Research, Rockville, MD 20852.
Objective:
The volume and cost of services consumed by persons with AIDS (PWAs) during their last months of life are examined in this study.
Data Sources:
This study utilizes data from the AIDS Costs and Service Utilization Survey (ACSUS). The ACSUS is the most comprehensive survey of medical services that are consumed by persons with HIV.
Study Design:
This study is restricted to persons with AIDS who survived the fifth time period (an approximately three-month period in the early spring and summer of 1992). The types and costs of services consumed during the fifth time period by PWAs who did survive (609) and who did not survive (79) the sixth time period are compared.
Data Collection:
The ACSUS consists of six interviews over an 18-month period from Spring 1991 to Fall 1992.
Principal Findings:
Decedents were hospitalized more than four times as many days and experienced more than four times the number of home health visits as survivors. Both the average length of stay (19.3 days for decedents and 10.3 for survivors) and the frequency of hospitalization during the fifth time period (.70 for decedents and .28 for survivors) were higher for decedents than survivors. The levels of outpatient care (including emergency room care) and of prescription drug use were similar for decedents and survivors.
Conclusions:
This study shows that the cost of treating decedents is more than three times the cost of treating survivors.