Higher AIDS Hospital Costs Seen by Study

Current estimates of the hospital costs of caring for people suffering from AIDS-related conditions severely understate the burden on medical facilities because the figures are based upon an AIDS definition drafted years ago by federal health officials, according to a national study released Tuesday.

The study, which surveyed 700 public and private hospitals about their 1988 admissions, said that for every 100 hospital admissions for AIDS, an additional 53 were made to treat conditions related to infection with the human immunodeficiency virus--although the latter patients did not meet the Centers for Disease Control’s clinical definition of AIDS.

The study was published this week in the Journal of the American Medical Assn.

The CDC, which has been tracking the epidemic since it began 11 years ago, has proposed expanding the AIDS definition to include anyone with 200 or fewer CD4 cells per milliliter of blood, an indication of a seriously compromised immune system. The normal range of these cells--which are the primary target of HIV--is between 800 and 1,000.

Nevertheless, the CDC has been criticized for not expanding the definition even further to include other conditions, such as pulmonary tuberculosis and certain gynecological disorders common to HIV-infected women.

The study found that almost 75% of the patients outside the current AIDS definition were dependent on public aid, which the report predicted will stretch hospitals, particularly those in the inner city, “beyond capacity.”

That is, not only will the hospitals be unable to cope with all the patients but, because government payments to hospitals often do not cover the institutions’ costs, their financial health will be impacted as well.

“The substantial costs to individuals and to institutions require that any future policies must reduce barriers impeding coverage and treatment to the total population of HIV-infected individuals,” the report recommended.