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Demographic and socio-economic determinants of community and hospital services costs for people with HIV/AIDS in London
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Kupek, Emil, Dooley, Mary, Whitaker, Luke, Petrou, Stavros and Renton, Adrian (1999) Demographic and socio-economic determinants of community and hospital services costs for people with HIV/AIDS in London. Social Science & Medicine, 48 (10). pp. 1433-1440. doi:10.1016/S0277-9536(98)00447-X
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Official URL: http://dx.doi.org/10.1016/S0277-9536(98)00447-X
Abstract
We examined the influence of demographic, social and economic background of people with HIV/AIDS in London on total community and hospital services costs. This was a retrospective study of community and hospital service use, needs and costs based on structured questionnaires administered by trained interviewers and costing information obtained from the service purchasers and providers, based on two Genito-urinary Medicine clinics in London: the Jefferiss Wing at St. Mary's Hospital and Patric Clements at the Central Middlesex Hospital, London, England. The subjects were 225 HIV infected patients (105 asymptomatic, 59 symptomatic non-AIDS and 61 AIDS). We found that over and above well established determinants of health care costs for HIV infected people such as disease stage and transmission category, social and economic factors such as employment and support of a living-in partner significantly reduced community services costs. Private health insurance had a similar effect, though only a small proportion of HIV people had such cover. The cost of community services for HIV infected non-European Union nationals, mainly of African origin, was one quarter that for the European Union nationals. Community services costs were highest for heterosexually infected women and lowest for heterosexually infected men after adjusting for other factors. Hospital services costs were significantly higher for HIV infected people lacking educational qualifications and employment. We conclude that access to community care for HIV infected non-EU nationals appears to be very poor as the cost of their community services was one quarter that for the EU nationals after adjusting for the effects of transmission category, disease stage, living with a partner, employment and having a private health insurance. Additional incentives for informal care for HIV infected people could be a cost-effective way to improve their community health service provisions.
| Item Type: | Journal Item | ||||
|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | ||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Social Science & Medicine | ||||
| Publisher: | Elsevier | ||||
| ISSN: | 0277-9536 | ||||
| Official Date: | 16 June 1999 | ||||
| Dates: |
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| Volume: | 48 | ||||
| Number: | 10 | ||||
| Page Range: | pp. 1433-1440 | ||||
| DOI: | 10.1016/S0277-9536(98)00447-X | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Conference Paper Type: | Paper |
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