LIMITATIONS OF AIDS REPORTING UNDER FAVORABLE CIRCUMSTANCES

To assess completeness of acquired immunodeficiency syndrome (AIDS) re porting by a consortium of Philadelphia physicians, we compared the co nsortium's patient data base to AIDS case reports received by the Phil adelphia Department of Public Health (PDPH). Several circumstances fav ored better than ordinary reporting. Consortium physicians were highly motivated, specialized in the care of patients with human immunodefic iency virus disease, had worked with PDPH physicians for years, and kn ew beforehand about the plan to compare data bases. Of 295 patients in the consortium data base diagnosed with AIDS at least nine months pri or to this study, 267 (90.5%) had been reported to the PDPH and 28 (9. 5%) had not. Only two of the missed reports were deliberately withheld , each in response to the patient's request. Reporting completeness in creased with the time elapsed since diagnosis, varied by practice from 70% to 100%, and was unrelated to patient demographic, insurance stat us, or occupational characteristics. AIDS reporting for patients in he alth care occupations (11/13 = 85% reported) was not significantly dif ferent from reporting for patients in other occupations (256/282 = 91% reported). We conclude that, under conditions favorable to reporting, approximately 10% of AIDS patients are not reported; the only patient characteristic that predicts reporting is the time elapsed since diag nosis; and nearly all reporting failures are inadvertent.