Analysis of hospitalization expenses of 610 HIV/AIDS patients in Nantong, China

Abstract

Background: The goal of this study was to describe the expenses related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) management and care in Nantong Infectious Disease Hospital from October 2013 through June 2017. Methods: The information of 610 HIV/AIDS inpatients were collected from the Electronic Medical Record System of the hospital. Univariate and path analysis were employed to evaluate the association between hospitalization expense and its related factors. Results: The average hospitalization expenses per person was 5454 RMB (Renminbi, the currency of China, about $808 USD) and 23,555 RMB (about $3489 USD), respectively for HIV/AIDS patients. The average length of hospital stay was 10.0 ± 5.5 days for HIV patients and 21.7 ± 12.4 days for AIDS patients. For HIV patients, laboratory test fees constituted 37.46% of total expenses; while drug fees accounted for the largest proportion for AIDS patients. Path analysis indicated that the length of hospital stay was the most important factor affecting total expenses (total path coefficient = 0.563 for HIV patients and 0.649 for AIDS patients). Total expenses for HIV-infected females was higher than that of males (total path coefficient = 0.217), and the more complications led to higher expenses for AIDS patients. Conclusions: Though antiretroviral therapy (ART) is provided for free in China, associated medical care, particularly hospitalizations and fees, continue to drive up the medical costs of patients living with HIV and AIDS. Understanding the factors influencing these costs are crucial for determining policies and strategies that can reduce the economic burden of HIV/AIDS patients in China.

Resource Utilization and Caring Cost of People Living with Human Immunodeficiency Virus (PLHIV) in Saudi Arabia: A Tertiary Care University Hospital Experience

“…This was driven by the admission of few PLHIVs in that year to the intensive care unit (ICU) to treat HIV-related co-morbidities and opportunistic infections. This result is similar to results from recent studies among PLHIV in France, Italy, and China which showed that most patients presenting to the hospital with an opportunistic infection or co-morbidity had increased hospitalization costs [ 9 , 29 , 43 , 44 , 45 ]. This evidence highlights the importance of proper initiation and tailoring of ARTs and management of co-morbidities among PLHIV in order to reduce such spending [ 29 ].…”

Treatment persistence of bictegravir/emtricitabine/tenofovir alafenamide and efavirenz+lamivudine+tenofovir disoproxil among HIV-1 patients newly starting treatment in China

“…After government reimbursement (≥ 70%), the out-of-pocket expenditure of BIC/FTC/TAF could still be a barrier for HIV patients, especially in HIV patients with low socio-economics status or in rural areas. Previous studies have shown that even in HIV/AIDS patient with the free ART, the out-of-pocket expenditure is still high because of the other costs related with laboratory tests, examinations, medical service and drugs for opportunistic infections, which are not covered by the government [35,36]. A study conducted in Nantong in 2017 shows the annual hospitalization expense per HIV patient with free ART is CNY 5,454, which is slightly higher than the annual out-of-pocket expenditure of BIC/FTC/TAF, indicating a potential heavy economic burden to HIV patients taking BIC/FTC/TAF [35].…”

“…Previous studies have shown that even in HIV/AIDS patient with the free ART, the out-of-pocket expenditure is still high because of the other costs related with laboratory tests, examinations, medical service and drugs for opportunistic infections, which are not covered by the government [35,36]. A study conducted in Nantong in 2017 shows the annual hospitalization expense per HIV patient with free ART is CNY 5,454, which is slightly higher than the annual out-of-pocket expenditure of BIC/FTC/TAF, indicating a potential heavy economic burden to HIV patients taking BIC/FTC/TAF [35]. Considering the large number of HIV patients with low socio-economic status or in rural area, additional nancial support needs to be prioritized to help HIV patients have access to drugs with better safety and e cacy pro le.…”

Subdividing ART patients and analyzing the medical burden by modeling of CD4 cell count

“…[ 3 , 4 , 12 13 14 15 16 ] The factors of drug and testing fees were found to dominate the medical costs of ART. [ 3 , 17 ] Suggestions to decrease the cost included the use of generic drugs,[ 7 ] novel antiretroviral drugs, or alternative CD4 cell count test technology. [ 3 , 5 , 7 , 14 , 15 ] Nevertheless, these suggestions have limitations.…”