AEGiS-08IAC: Practice guidelines for pediatric HIV care: methods of calculating costs.

8th International AIDS Conference


Amsterdam, Netherlands — July 19-24, 1992

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Practice guidelines for pediatric HIV care: methods of calculating costs.

Int Conf AIDS 1992 Jul 19-24; 8:We51 (abstract no. WeC 1037)
Glied S, Sisk JE; Columbia University School of Public Health, New York, NY.

OBJECTIVES: 1) To develop and evaluate a method of calculating the cost implications of practice guidelines for pediatric HIV care and 2) to compare alternative methods of estimating the per unit cost of services to pediatric HIV patients.

METHODS: From records of 3 New York City hospitals, we abstracted the services provided for 18 months to the first 100 pediatric HIV patients treated in 1990. We devised a procedure to compare actual care provided to these children, whose HIV status ranged from P0 through P2, to New York State's 1991 guidelines for pediatric HIV care. For each child, total costs equaled the sum of the number of specific services times the per unit costs of each service. Alternative methods were used to calculate per unit cost: hospital's billed charges, ratio of costs to charges, and two New York State payment methods.

RESULTS: The guidelines specify elements of history-taking and counseling that, even if routinely performed, have not traditionally been entered in the medical record. Compared with central hospital records, records for HIV clinics document more services provided to specific patients.

CONCLUSIONS: Given their incompleteness, central hospital records are likely to underestimate the services provided to pediatric HIV patients and estimates based on these records are likely to understate the costs of care. Cost-to-charge ratios may better approximate economic costs than billed charges, but both are likely to diverge from actual resources used.

Keywords: AEGIS, HIV, Costs and Cost Analysis, HIV Infections, Guidelines, Learning, Memory, Counseling, Recognition (Psychology), HIV Seronegativity, New York, New York City, Child, Human, methods, standards, economics, immunology, ICA8KWDaegis,hiv,costsandcostanalysis,hivinfections,guidelines,learning,memory,counseling,recognition(psychology),hivseronegativity,newyork,newyorkcity,child,human,methods,standards,economics,immunology,ica8
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WeC1037

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.