The cost of treating persons with AIDS in four hospitals in metropolitan New York in 1985.

From hospital accounting data on 402 patients, this study calculated annual, lifetime and perdiem cost, assessed the relationship to cost risk group, diagnosis, payer, and DRG, and estimated how the cost burden was shared between hospitals and third-party payers. Conclusions were as follows: Annual impatient hospital cost for adults with AIDS averaged +22,300, incurred during an average of 38 hospital days. Lifetime inpatient hospital costs averaged +38,200, incurred during an average of 62 hospital days. Patients with AIDS did not make more intensive use of hospital ancillary services than the average medical/surgical patient. They incurred exceptional per diem costs for laboratory and pharmacy services, but this was offset by lower operating room costs. Cost did not bear a statistically significant relationship to risk group in adult patients, but hospital utilization, and thus annual cost, ws very different for pediatric patients. There was limited evidence of a relationship between cost and diagnosis and between cost and payer. Eighty-two percent of the total cost was reimbursed by third-party payers: Medicaid (28 percent), Blue Cross (26 percent), Medicare (3 percent) and commercial insurance and other payers (25 percent). We estimate that self-pay patients paid 13 percent of the cost, and that 5 percent was unreimbursed.