L.A. Outspent San Francisco in Aid for AIDS

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, contrasted with $1,514 in San Francisco, and the average hospital stay was 13.3 days in Los Angeles and 9.5 days in San Francisco. Comparative figures were not available for Orange County.

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

Won’t ‘Break the Bank’

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.

Two Orange County hospitals were among the top 40 hospitals in the state to treat Medi-Cal AIDS patients. UCI Medical Center in Orange was 12th, with 137 claims totaling $1 million from August, 1982 through March, 1988. Hoag Memorial Hospital Presbyterian in Newport Beach was 16th in that period, with 89 claims totaling $721,000.

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

L.A. Caseload to Rise

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%.

The report listed 110 Medi-Cal AIDS cases from Orange County from 1981 to 1988, accounting for 3.2% of the state’s Medi-Cal caseload in that time. Last year, four cases or 7% of the state’s Medi-Cal caseload came from Orange County. Overall, Orange County has recorded 923 AIDS cases from 1981 through 1988, with 539 deaths in that time.

Staff writer Lanie Jones in Orange County contributed to this story.