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Lifetime cost of care for children with human immunodeficiency virus infection
P L Havens1, B E Cuene, D R Holtgrave
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
Insights
Caring for children with HIV infection is costly, with average lifetime expenses nearing $500,000 per child. This data is crucial for economic analyses of HIV prevention strategies in pregnant women.
Area of Science:
- Pediatric Infectious Diseases
- Health Economics
- Public Health Policy
Background:
- Understanding the cost of care for pediatric HIV is essential for evaluating public health interventions.
- Economic impact analysis requires accurate cost data for children with HIV infection.
Purpose of the Study:
- To estimate the comprehensive lifetime cost of medical care for children diagnosed with HIV infection.
- To provide data for economic evaluations of HIV prevention programs for pregnant women.
Main Methods:
- Retrospective cohort study of 88 children with or at risk for perinatally acquired HIV.
- Analysis of medical records and hospital financial data to calculate inpatient and outpatient charges.
- Kaplan-Meier survival analysis to estimate time in different CDC HIV categories.
Main Results:
- Mean lifetime hospital-based charges were estimated at $408,307 per child.
- Mean total lifetime charges, including non-hospital costs, were estimated at $491,936.
- Cost estimates ranged from $207,490 to $600,649 per child.
Conclusions:
- The medical care for children with HIV infection represents a significant financial burden.
- These cost estimates are vital for informing healthcare planning and policy decisions regarding HIV prevention.
- Data supports the economic evaluation of universal counseling and voluntary HIV testing for pregnant women.
Background:
Knowledge of the cost of care for children with HIV infection is necessary to analyze the economic impact of recommendations for universal counseling and voluntary HIV testing of pregnant women.
Objectives:
To estimate the total cost of care for children with HIV infection.
Methods:
We performed a retrospective cohort study of all 88 children with (n = 29) or at risk for (n = 59) perinatally acquired HIV infection cared for at Children's Hospital of Wisconsin between February 2, 1987, and June 1, 1995. Review of medical records for all 29 children with perinatally acquired HIV infection or AIDS identified: date of HIV diagnosis; date of classification into Category N, A, B or C; date of AIDS diagnosis; and date of death or transfer of care. The time each subject remained in each CDC category was calculated and the Kaplan-Meier product-limit method was used to calculate survival time for all patients in each CDC category. Hospital-based inpatient and outpatient charges per patient per month in each CDC category (N, A, B, C and AIDS) were calculated with information from the hospital financial services database, and lifetime hospital-based inpatient and outpatient charges were estimated as the sum of the charges for each category. From that, total charges were calculated assuming that hospital-based charges were 83% of total charges.
Results:
Based on a median survival time of 120 months, the mean lifetime charges for hospital-based care for children with HIV infection was $408307 (estimates ranged from $172217 to $498539). If hospital-based care represents 83% of the total charges for care of children with HIV infection, then mean total lifetime charges for care of children with HIV infection were $491936 ($207490 to $600649).
Conclusions:
The care of children with HIV infections is expensive. This information may be useful in planning for care programs and for analyzing the economic impact of recommendations for universal counseling and voluntary HIV testing of pregnant women.