30,000 New AIDS Cases Expected in State by 1991

State health officials are estimating that 30,000 to 40,000 Californians will be stricken with AIDS by 1991--an estimate that would mean as much as $600 million in additional Medi-Cal costs.

The estimates also would mean as much as $2.7 billion in private health spending in the next five years to pay for the acquired immune deficiency syndrome epidemic.

“Over the next several years, there are going to be huge expenditures,” Dr. Kenneth W. Kizer, director of the state Department of Health Services, said in an interview with The Times.

The statistics were compiled for a study on the impact of AIDS in California, the first such study by the state government. Kizer emphasized that the numbers were only estimates made for planning purposes, and that they could change with advances in treatment and with the increased effectiveness of AIDS-prevention programs.

The figures, however, are based on the assumption that the explosive rate of increase in new AIDS cases has already begun to slow. Instead of assuming that the number of cases will double each year--the national trend for several years--state officials estimated that the annual rate of increase would drop to 50% or less, said Dr. James Chin, who heads the department’s infectious diseases section.

In San Francisco, where an intensive education program has been put into place, the rate of increase in new cases has actually dropped to about 50% this year, said Richard Fox of the department’s AIDS unit. But such is not yet true of the state as a whole, he said.

Even if the growth in new cases does slow, the result will still be a staggering number of cases of the fatal disorder.

As of Friday, the national Centers for Disease Control in Atlanta had received reports of 15,581 confirmed AIDS cases across the nation since the disease was identified in 1981 in certain high-risk groups--primarily homosexual men and intravenous drug users. Federal officials estimate that number will double next year, and the CDC has not made any longer-range projects, according to Charles Fallis, a CDC spokesman.

Disproportionate Share

California has experienced a disproportionate share--3,582 as of Nov. 30. Of those patients, 57%, or 2,042, were still alive and undergoing treatment.

The department’s study estimates that by 1990 there will be more than 12,000 AIDS patients being treated in California--about one-fourth of them under the state-run Medi-Cal program, which provides health care to low-income individuals.

Kizer noted that the average life expectancy of AIDS patients is about 18 months after the disease is diagnosed. Almost all patients--98% of them--die within five years, he said.

The cost of care is high. Most AIDS patients require frequent hospitalization, once every three months on average, for treatment of life-threatening infections or a rare and rapidly spreading form of cancer.

$59,000 Medi-Cal Cost

A department survey showed that the average cost per patient from diagnosis to death is $59,000 under Medi-Cal and $91,000 for private-care patients, according to John Rodriguez, who heads the department’s Medi-Cal program.

Using those figures, 10,000 AIDS patients covered by Medi-Cal during the next five years would require $590 million in treatment; 30,000 private-care patients would spend $2.7 billion.

The costs in California are far less than the national average of more than $140,000 per patient, the Centers for Disease Control reported.

The costs are lower in San Francisco than in Los Angeles, where hospital stays tend to be longer, Rodriguez said. At least 12% of AIDS patients receive care paid for by Medi-Cal, he said.

Kizer noted that it has been difficult to determine what proportion of care for AIDS patients has been covered by Medi-Cal. Hospitals and doctors applying for reimbursement have not been required to identify AIDS patients or AIDS-related conditions. That will change next year, when new rules go into place requiring that AIDS-related diseases be clearly identified on Medi-Cal reimbursement forms.