THE EFFECT OF CASE MANAGEMENT ON COST OF CARE FOR PERSONS WITH AIDS (PWAS) (IMMUNE DEFICIENCY).
Contributors: Medical College of Georgia.
Published: 1990
Number of pages: 170
Subjects: Health Sciences, Public Health.; Health Sciences, Health Care Management.; Health Sciences, Nursing.
Description: Acquired Immunodeficiency Syndrome (AIDS) has become the most serious public health problem in recent history. Experts predict that by 1992, there will have been 365,000 cases of AIDS reported in the United States (U.S.). The study design consisted of a retrospective review of the hospital records of 150 individuals who died of AIDS. Hospital charges associated with hospital care for individuals using the AID Atlanta case management system (n = 75) were compared to the charges for individuals using four hospitals providing a traditional, non-coordinated approach to services (n = 75).

Hypothesis one postulated that PWAs in Georgia who received care within a case management model would have significantly lower mean diagnosis-to-death hospital based charges than PWAs receiving care in a non-case management system. This hypothesis was partially supported by the findings of this study. The mean hospital charges for subjects in the case managed group were significantly lower than for those in the non-case managed group. However, there was no between group difference in total days of hospitalization, number of admissions, or average length of stay.

The mean diagnosis-to-death charge associated with hospital care for this sample was $21,394, which is significantly lower than the Hardy et al (1986) figure of \$147,000 associated with the care of the first 10,000 cases of AIDS reported in the United States. The patient characteristics examined were: (1) history of intravenous drug abuse, (2) the number of opportunistic infection developed, (3) the type of opportunistic infection developed, (4) race, (5) treatment with AZT, and (6) type of care received (i.e. case managed versus non-case managed). Type of care received and number of infections were the only variables found to account for significant variance in hospital charges.

The results of supplementary analysis revealed that PWAs in the case managed group lived significantly longer between their first hospital admission and death, as compared to the non-case managed group. Additionally, 47.3% of the sample (N = 150) received their HIV diagnosis during their first hospital admission.
Notes: Source: Dissertation Abstracts International, Volume: 51-08, Section: B, page: 3802.

Thesis (PH.D.)--MEDICAL COLLEGE OF GEORGIA, 1990.

School code: 0305.