The average U.S. hospital lost $92,000 in 1991 treating AIDS and HIV patients, with teaching and public hospitals shouldering a disproportionate share of the burden, according to a report by a public health group.
AIDS and HIV patients require longer hospital stays than typical patients and often are dependent on Medicaid, Medicare or charity care, which contributes to treatment losses, the National Public Health and Hospital Institute report said.
Nearly half of AIDS and HIV patients relied on Medicaid to cover inpatient care, estimated at $1.6 billion in 1991.
Public funds and charity care accounted for 90% of AIDS- and HIV-related compensation at public hospitals and 83% of such payment at teaching hospitals in 1991, the report said. About 60% of AIDS- and HIV-related payments at private-sector hospitals are from public-sector or charity-care sources.
Institute President Dennis Andrulis used the data to characterize AIDS care as a public-sector responsibility jeopardized by proposed cuts in Medicaid and Medicare.
"Any federal action that significantly reduces Medicaid and Medicare payments will only act as a strong incentive for institutions to limit HIV care to limit their losses," Andrulis said.
Patricia Fleming, national AIDS policy director, agreed. She said proposals to cut Medicaid spending growth by up to $184 billion over seven years is to AIDS and HIV victims "as much of a threat as the virus in their bodies."
Teaching hospitals are particularly burdened by AIDS and HIV treatment because they have become "magnets" for such care, although their cost picture has improved somewhat, the institute said.
In 1991, teaching hospitals on average lost $260,000 on AIDS and HIV treatment. That loss, however, was down from nearly $541,000 in 1988, reflecting control over utilization that kept cost growth slower than revenue growth.
The institute's report on data from 1,100 hospitals is published in the most recent edition of Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology.
Public Private Teaching All
Medicaid 54.9% 41.0% 52.2% 48.1%
Medicare 5.6 8.4 5.5 7.0
Insurance 10.6 37.8 17.0 23.6
Other 28.9 12.8 25.3 21.3
Financial impact of AIDS/HIV care on hospitals
Per day Per admission Per inpatient year
Cost $833 $9,585 $14,816
Revenues 774 8,940 13,589
Net income 59 (645) (1,227)
Source: National Public Health and Hospital Institute