The changing direct costs of medical care for patients with HIV/AIDS, 1995-2001.
Bibliographic record
Abstract
BACKGROUND: Determining the direct cost of providing medical care to patients with HIV/AIDS is important for both short-term and long-term decision-making and for appropriate resource allocation. We aimed to categorize and measure the direct costs of medical care provided to the entire HIV-positive population receiving care in southern Alberta between 1995 and 2001. METHODS: We collected all patient-specific direct costs including the cost of pharmaceutical drugs (HIV and non-HIV drugs), outpatient care (including physician costs and laboratory testing), inpatient (in-hospital) care and home care (acute, long-term, palliative) from primary sources for all patients between April 1995 and April 2001. We determined cost per patient per month (PPPM) adjusted to 2001 Canadian dollars. RESULTS: Since 1995, the direct cost of providing medical care to patients with HIV/AIDS has increased primarily as a result of increased antiretroviral drug costs both in absolute and in PPPM terms. Mean PPPM expenditures increased from 655 Canadian dollars in 1995/96, that is, before the use of highly active antiretroviral therapy (HAART), to 1036 Canadian dollars in 1997/98 when HAART was widely used. During the following 3 years, mean overall PPPM costs remained stable. Antiretroviral drugs accounted for 30% (198 Canadian dollars PPPM) of the total cost in 1995/96 increasing to 69% (775 Canadian dollars PPPM) in 2000/01. Inpatient, outpatient and home care costs decreased in both percentage and cost PPPM between 1995/96 and 2000/01 from 26% to 10%, 27% to 14% and 8% to 3% respectively. INTERPRETATION: The cost of providing medical care to HIV-positive patients continues to increase, although the burden of costs is distributed differently from before the introduction of HAART, with the costs of drug therapy offsetting the costs of inpatient care and home care. Careful consideration of all aspects of direct costing data is needed when any health economic policy issues are examined.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".