Costs associated with hospitalization in HIV-positive patients in France

OBJECTIVES:To estimate the number of patients hospitalized for HIV-related reasons in France, to describe their characteristics and to estimate hospitalization-associated costs. DESIGN:A retrospective analysis of the French hospital medical information database (Programme de médicalisation des systèmes d’information en médecine, chirurgie, obstétrique et odontologie database). METHODS:Patients hospitalized with HIV in France in 2013 and 2014 were identified in the database through International Classification of Diseases, 10th revision diagnostic codes as well as comorbidities and opportunistic infections. Hospital stays for each patient were extracted over a 12-month period following the initial index hospitalization. Costing was performed from the perspective of national health insurance. Direct costs were attributed from national tariffs for medical acts and expressed in 2016 Euros. RESULTS:During the study period, 70 180 stays, including day (80%) and overnight (20%) hospitalization, of patients with HIV were identified, of which 37 477 stays (by 20 126 patients) were directly related to HIV. In patients with overnight hospitalization, an opportunistic infection was documented in 50% of patients and at least one comorbidity were identified in 85% of patients. The overall estimated total annual cost of hospital stays was 64 126 616 (median annual cost per patient 545). The median annual per capita cost was 541 for day hospitalization, 7664 for overnight stay with comorbidities and 9059 for overnight stay with opportunistic infections. CONCLUSION:Most patients hospitalized with HIV in France presented an opportunistic infection or at least one comorbidity that contributed to costs of hospitalization. The organization of interfaces between different healthcare providers in hospital and community practice needs to be organized so that comorbidities are identified and managed optimally.