Shortly after a National Institutes of Health publication carried the first warnings about AIDS in June 1981, it became apparent that the number of patients who had developed the deadly disease would only increase rapidly.
With what they knew at the time, hospital administrators saw a disaster in the making.
The earliest AIDS patients, because they were so sick with complications by the time they were diagnosed, were each costing hospitals $50,000 to $70,000 to treat, says Samuel Bozzette, M.D., an AIDS researcher for 15 years and a professor at the University of California at San Diego.
"What happened was, prevention got better. Anti-HIV drug therapy got better. Preventive therapy got better. And hospitalization rates declined through the first half of the 1990s," Bozzette says. Improved drug therapies are helping patients stay healthier longer while also slashing the inpatient costs of treatment. The Centers for Disease Control and Prevention estimates that 800,000 to 900,000 U.S. citizens are infected with HIV.
Home health agencies and hospices also have developed the expertise to care for AIDS patients outside the hospital, he says. These factors combined to reduce expenditures on AIDS patients to an estimated $6.8 billion in direct expenses for AIDS/HIV in 1996, Bozzette says.
"It's not like $6 billion or $7 billion isn't real money, but relative to total expenditures in the U.S. healthcare system, it isn't," he says