LIFETIME COST OF CARE FOR CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Background. Knowledge of the cost of care for children with HIV infect ion is necessary to analyze the economic impact of recommendations for universal counseling and voluntary HIV testing of pregnant women, Obj ectives, To estimate the total cost of care for children with HIV infe ction, Methods, We performed a retrospective cohort study of all 88 ch ildren with (n = 29) or at risk for (n = 59) perinatally acquired HIV infection cared for at Children's Hospital of Wisconsin between Februa ry 2, 1987, and June 1, 1995. Review of medical records for all 29 chi ldren with perinatally acquired HIV infection or AIDS identified: date of HIV diagnosis; date of classification into Category N, A, B or C; date of AIDS diagnosis; and date of death or transfer of care, The tim e each subject remained in each CDC category was calculated and the Ka plan-Meier product-limit method was used to calculate survival time fo r all patients in each CDC category, Hospital-based inpatient and outp atient charges per patient per month in each CDC category (N, A, B, C and AIDS) were calculated with information from the hospital financial services database, and lifetime hospital-based inpatient and outpatie nt charges were estimated as the sum of the charges for each category, From that, total charges were calculated assuming that hospital based charges were 83% of total charges, Results, Based on a median surviva l time of 120 months, the mean lifetime charges for hospital-based car e for children with HIV infection was $408 307 (estimates ranged from $172 217 to $498 539), If hospital-based care represents 83% of the to tal charges for care of children with HIV infection, then mean total l ifetime charges for care of children with HIV infection were $491 936 ($207 490 to $600 649), Conclusions, The care of children with HIV inf ection is expensive, This information may be useful in planning for ca re programs and for analyzing the economic impact of recommendations f or universal counseling and voluntary HIV testing of pregnant women.