Early HIV Diagnosis Leads to Significantly Decreased Costs in the First 2 Years of HIV Care in an Urban Charity Hospital in New Orleans. (November 2017)

• Record Type: Journal Article
• Authors: Halperin, Jason; Katz, Morgan; Pathmanathan, Ishani; Myers, Leann; Van Sickels, Nicholas; Seal, Paula Sereebutra; Richey, Lauren E.
• Is Part Of: Journal of the International Association of Providers of AIDS Care. Volume 16:Number 6(2017:Nov./Dec.)
• Page Start: 527
• Page End: 530
• Publication Date: 2017-11
• Subjects: HIV infection -- cost-effectiveness -- early diagnosis -- AIDS -- viral load -- CD4 lymphocyte count; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1177/2325957417737381
• Languages: English
• ISSNs: 2325-9574

Abstract

We undertook a retrospective cohort study of patients with a positive HIV test in the emergency department who were then linked to care. Inpatient, outpatient, and emergency costs were collected for the first 2 years after HIV diagnosis. Fifty-six patients met the inclusion criteria; they were predominantly uninsured (73%) and African American (89%). The median total cost for a newly diagnosed patient over the first 2 years was US$36 808, driven predominantly by outpatient costs of US$17 512. Median inpatient and total costs were significantly different between the lowest (<200 cells/mm 3 ) and highest (>499 cells/mm 3 ) CD4 count categories (US$21 878 vs US$6607, P <.05; US$61 378 vs US$18 837, P <.05, respectively). Total costs were significantly different between viral load categories <100 000 HIV-RNA copies/mL and ≥100 000 HIV-RNA copies/mL (US$28 219 vs US$49 482, P <.05). Costs were significantly lower among patients diagnosed earlier in their disease. Decreased cost is another factor supporting early diagnosis and linkage to care for patients with HIV.