Document Detail

Public funding of HIV/AIDS prevention, treatment, and support in California.
MedLine Citation:
PMID:  21546846     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the amount of public financing for HIV/AIDS in California and its distribution among treatment, prevention, and support services. To determine the geographical distribution of public financing for HIV/AIDS within California.
DESIGN: Data on HIV/AIDS expenditures were compiled across federal and state agencies supporting HIV/AIDS in fiscal year 2008.
METHODS: Federal and state data on programs that finance HIV/AIDS treatment, prevention, and support services, including the Ryan White Program, the Centers for Disease Control and Prevention, and the California General Fund, were compiled. California-specific expenditures for Medicare and Medicaid were calculated from claims data. Other entitlement program spending was estimated from national HIV/AIDS data. Data on AIDS cases by county were obtained from the California State Office of AIDS. Mapping to California counties was accomplished with Arc-GIS software.
RESULTS: Public funders accounted for approximately $1.92 billion in HIV/AIDS services in California in fiscal year 2008. Most (90.4%) supported treatment; prevention accounted for 6.4% and support services for 2.6%. The majority of treatment financing came from 2 Federal health entitlement programs, Medicare (36%), and Medicaid (28%). Counties with the highest case loads had lower expenditures per case, suggesting economies of scale.
CONCLUSIONS: Treatment expenditures overshadow prevention spending. The dominance of entitlement programs in funding for HIV/AIDS treatment challenges policy makers to monitor the extent and quality of HIV/AIDS care in California. A unified health information system for HIV/AIDS that bridged the fragmented health payment system's data silos would benefit policy makers' efforts to monitor the delivery of HIV/AIDS services.
Arleen A Leibowitz; Alison C Mendes; Katherine Desmond
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  58     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-22     Completed Date:  2011-11-02     Revised Date:  2014-02-26    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e11-6     Citation Subset:  IM; X    
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MeSH Terms
Anti-HIV Agents / economics*,  therapeutic use*
California / epidemiology
Delivery of Health Care / economics
Financing, Government / organization & administration*
HIV Infections / drug therapy,  economics*,  epidemiology,  prevention & control*
Health Services / economics*
Health Services Accessibility / economics
Grant Support
Reg. No./Substance:
0/Anti-HIV Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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