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Original ArticleOpen Access
The Mounting Medical Care Cost for Adult AIDS Patients at the Faculty of Medicine, Siriraj Hospital : Consideration for Management
Suwanagool S 
,
Ratanasuwan W ,
Techasathit W
,
Ratanasuwan W ,
Techasathit W From January 1993 to December 1995, case records of adult AIDS and HIV symptomatic
patients admitted in the Department of Medicine, observation room and HIV Counseling Clinic
were reviewed for the medical care cost of the patients based on the 1995 value of the Thai baht.
In the three years, a total of 196, 227 and 182 adult AIDS case were admitted as in-patients respectively.
The median duration of admission was 14 days. The leading causes of admission were
tuberculosis, cryptococcal meningitis, Pneumocystis carinii pneumonia, diarrhea, salmonellosis and
toxoplasmosis. An increase in the number of AIDS patients in the observation room was observed :
from 572 cases in 1993 to I ,205 cases in 1995. In addition, approximately 600 AIDS cases were
followed up at four to eight week intervals. The analysis of the data found an average medical
care cost for hospitalized patients to be 1,452 baht per day while in the observation room it was
1,509 baht per day and 1,132 baht per month for the patients attending the HIV and Counseling
Clinic. Because of the higher number of cases and the limited number of admission beds, only 15
per cent of AIDS patients in the observation room could be admitted as hospitalized patients. At
present, it is urgent that a referral network be established among all university hospitals, all government
hospitals and health centers. In this way, the more advanced medical facilities can serve as a
primary diagnostic center which can refer patients for care and follow-up based on an established
referral system. In addition, the development of a hospice service and community care is needed
for cases in the terminal stage of the illness.
patients admitted in the Department of Medicine, observation room and HIV Counseling Clinic
were reviewed for the medical care cost of the patients based on the 1995 value of the Thai baht.
In the three years, a total of 196, 227 and 182 adult AIDS case were admitted as in-patients respectively.
The median duration of admission was 14 days. The leading causes of admission were
tuberculosis, cryptococcal meningitis, Pneumocystis carinii pneumonia, diarrhea, salmonellosis and
toxoplasmosis. An increase in the number of AIDS patients in the observation room was observed :
from 572 cases in 1993 to I ,205 cases in 1995. In addition, approximately 600 AIDS cases were
followed up at four to eight week intervals. The analysis of the data found an average medical
care cost for hospitalized patients to be 1,452 baht per day while in the observation room it was
1,509 baht per day and 1,132 baht per month for the patients attending the HIV and Counseling
Clinic. Because of the higher number of cases and the limited number of admission beds, only 15
per cent of AIDS patients in the observation room could be admitted as hospitalized patients. At
present, it is urgent that a referral network be established among all university hospitals, all government
hospitals and health centers. In this way, the more advanced medical facilities can serve as a
primary diagnostic center which can refer patients for care and follow-up based on an established
referral system. In addition, the development of a hospice service and community care is needed
for cases in the terminal stage of the illness.
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