Hospital care for persons with AIDS in the European Union.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Hospital care for persons with AIDS in the European Union.

Health Policy. 1997 Aug;41(2):157-76. Unique Identifier : AIDSLINE MED/97417143
Postma MJ; Tolley K; Leidl RM; Downs AM; Beck EJ; Tramarin AM; Flori YA; Santin M; Antonanzas F; Kornarou H; Paparizos VC; Dijkgraaf MG; Borleffs J; Luijben AJ; Jager JC; Department of Public Health Forecasting, Bilthoven, The Netherlands.

Abstract: This study estimates the current and future hospital resources for AIDS patients in the European Union (EU), using multinational scenario analysis (EU Concerted Action BMH1-CT-941723). In collaboration with another EU-project ('Managing the Costs of HIV Infection'), six national European studies on the utilization of hospital care for AIDS have been selected to provide the data for our analysis. The selection criteria involve recentness, quality, comparability, accessibility and representativeness. Baseline hospital resource utilization is estimated for hospital inpatient days and outpatient contracts, using a standardized approach controlling for two severity stages of AIDS (chronic stage and late stage). The epidemiological part of the study is based on standard models for backcalculating HIV incidence and projecting AIDS incidence, prevalence and mortality. In the next step, baseline resource utilization is linked to epidemiological information in a mixed prevalence and mortality-based approach. Several scenarios render different future epidemiological developments and hospital resource needs. For the year 1999, hospital bed needs of 10,000-12,700 in the EU are indicated, representing an increase of 20-60% compared to the estimated current (1995) level. The projected range for 1999 corresponds to a maximum of 0.65% of all hospital beds available in the EU. The growth in the number of outpatient hospital contacts is projected to possibly exceed that of inpatient days up to 1.82 million in 1999. Our methodology illustrates that estimation of current and future hospital care for AIDS has to be controlled for severity stages, to prevent biases. Further application of the multinational approach is demonstrated through a 'what-if' analysis of the potential impact of combination triple therapy for HIV/AIDS. Estimation of the economic impact of other diseases could as well benefit from the severity-stages approach.

Keywords: *Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY *Acquired Immunodeficiency Syndrome/THERAPY *Hospitals/UTILIZATION
971130
M97B1218

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