AIDS Patient Costs in L.A. Higher Than S.F.

The state Medi-Cal program spent about twice as much money per AIDS patient in Los Angeles last year as in San Francisco, according to a report issued Wednesday by the California Department of Health Services.

Shorter hospital stays, made possible by the Northern California city’s extensive system of hospices and home health care, accounted for most of the difference. Daily hospital charges were also 15% less in San Francisco.

All told, Medi-Cal expenditures per AIDS patient per month were $2,953 in Los Angeles, compared to $1,514 in San Francisco, and the average hospital stay was 13.3 days in Los Angeles and 9.5 days in San Francisco.

“The message here is that the economic burden of AIDS can be significantly reduced by aggressively pursuing alternatives to in-patient hospital care,” said Dr. Kenneth W. Kizer, director of the Department of Health Services, in an interview.

Medi-Cal paid the health-care costs for 33% of the state’s AIDS patients last year, up from 27% in 1986 and 19% in 1983. Medi-Cal’s AIDS-related expenditures have kept pace, rising to $42.8 million in the current fiscal year. They are expected to climb to $56.4 million next year.

Despite the hefty tab, the report indicated that AIDS costs won’t overwhelm the state, as some have feared. “You can’t say that AIDS is going to break the bank, or bankrupt the (Medi-Cal) system,” said Kizer, noting that the state will spend a total of $6.5 billion on the program this year.

He acknowledged, however, that the epidemic has severely strained certain regions and institutions, particularly public hospitals in Los Angeles and San Francisco.

And while the epidemic will continue to take a disproportionate toll on San Francisco, that city will likely account for a declining percentage of the state’s AIDS cases in the future.

San Francisco accounted for 43% of the state’s new cases in 1982 but will drop to 26% in 1990, according to the report. Meanwhile, Los Angeles’ share of the caseload will rise from 34% to 38%, and all other areas of the state will go from 23% of new cases to 36%.

“This is a statewide issue,” Kizer said. “Over time, there is no community in California that will not be touched by AIDS in a very personal way.”

The Medi-Cal report was presented to a meeting here of the California AIDS Leadership Committee, a statewide group developing a comprehensive approach to combatting the disease. Kizer is co-chair of the committee.

Since the first cases of acquired immune deficiency syndrome were reported in 1981, about one-fourth of all cases reported in the United States have been from California.