Economic Aspects of AIDS and HIV Infection

From the early days of its recognized occurrence, AIDS has been per ceived as posing tremendous threats, burdens and challenges to human beings. Individuals, societies and, in a global point of view, mankind are affected by the effects of the HN infection, the nature and extent of which is still unclear in many ways. In the beginning only biomedical and epidemiological analyses of the problem were the top research priori ties, the former laden with great hopes that it may soon be possible to stop the spread of the disease and to overcome its physical impact. Yet it soon became clear that AIDS would be something to be reckoned and coped with on a long-term basis, making a thorough investigation of its impact absolutely mandatory. AIDS has serious economic consequences. Taken seriously, they can not be confined to predictions of costs intended to support the AIDS issue in the struggle for resources. Besides cost calculations - a method ologically tricky and wide-ranging topic in itself -and their application to cost-effectiveness and other analyses, economic issues include identify ing and assessing patterns of care, analyzing problems of financing, exploring impacts on markets other than health care, and modelling scenarios for future developments and strategies. At present, the eco nomic aspects of AIDS still constitute a very recent topic in European health economics and health systems research. Many projects are just about to start, and there must be a better exchange of information between research groups.

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This state of the art overview focuses on the economic and social consequences of AIDS, a topic which has been disregarded so far due to the focus on epidemiologic and biomedical aspects. There are thirty-one papers concerning a number of European and some other countries. The contributions are based on a conference funded by the European Communities.

Contenu
Social Sciences, Economics and AIDS.- Exploring Spread and Context of AIDS and HIV Infection.- Patterns of AIDS and HIV Infection in Europe.- Demographic Impact of Mortality from AIDS in France: Projection for 1991.- Social and Political Aspects of AIDS.- Economic Aspects of AIDS.- Patterns of Health Care and Social Support Systems.- The US Hospital AIDS Survey: Structure and Substance.- Description and Analysis of Patterns of Outpatient Care for AIDS Patients and HIV Infected Persons.- Social Support Systems for People Affected by AIDS. Observations from West Germany.- Use of Sentinel Systems in the Evaluation of the Impact of AIDS and HIV Infection.- Services for the Management of HIV Infection: Problems for Planners.- Costs of AIDS and HIV Infection.- Economic Evaluation of Programmes for AIDS and HIV Infection: Methodological Issues.- The Economic Analysis of Prevention of HIV Infection: Evaluation of Programmes and Decision Support for Priority Setting in Health Policy. Case Study. Sweden.- The Cost of AIDS and HIV Infection: Public Expenditures for AIDS Prevention in the Federal Republic of Germany.- The Costs of Hospital Care of AIDS Patients at the Teaching Hospital of the University of Amsterdam.- Direct and Indirect Costs of AIDS in Belgium: A Preliminary Analysis.- Hospital Costs for AIDS Patients.- Comparing Inpatient and Outpatient Costs for HIV, LAS and AIDS: Methodology, Results and Consequences from a Study in Germany.- Medical Services and Costs of AIDS Patients in an Outpatient Clinic for Infectious Diseases, Frankfurt University Hospital.- AIDS/HIV Costs in England: The Case of the Oxfordshire District.- The Regional Costs of AIDS in Spain.- Indicators and Trends of Direct and Indirect Costs of AIDS on a National Level: Results from Switzerland.- Costs of AIDS in a Developing Area: Indirect and Direct Costs of AIDS in Puerto Rico.- Financial Aspects.- Some Implications of AIDS for Permanent Health Insurance.- Scenarios and Policies.- Planning for AIDS or HIV Related Services in Greece: First Steps towards Operational Schemes.- Epidemiological Models and Socioeconomic Information: Methodological Aspects of AIDS/HIV Scenario Analysis.- Model-Based Scenarios to Describe Economic Impacts of AIDS: The Role of Case-Mix.- Scenarios as a Tool to Support Health Planning and Management.- Main Policy Issues of the Social and Economic Impact of AIDS from the Perspective of a Health Ministry.- Prospects.- The Economic Evaluation of Care Programmes for Patients with HIV-AIDS.- International Research Needs for AIDS.- Future Research Policies.- References.