Delivery and Financing Health Services in Five Communities

HRD-89-120: Published: Sep 13, 1989. Publicly Released: Sep 13, 1989.

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Pursuant to a congressional request, GAO examined the availability of health and social services for acquired immune deficiency syndrome (AIDS) patients in five communities, focusing on: (1) how the communities delivered and financed health services for AIDS patients; and (2) the federal implications of community and state actions.

GAO found that: (1) the size of the AIDS-patient population in each of the five communities has doubled nearly every year since 1981; (2) the communities ranged from those made up almost exclusively of homosexuals to those predominantly made up of or related to drug users, but most cities expected growth in cases related to drug use; (3) hospital care was generally available for AIDS patients, but caseloads were straining inpatient capacity; (4) outpatient care was reaching capacity; (5) nursing homes in most of the communities did not admit AIDS patients because of limited capacity and resources and low Medicaid reimbursement; (6) many home- and community-based services were not available to AIDS patients because of resource and insurance limitations; (7) lack of housing for AIDS patients was a serious problem in all five communities; and (8) Medicaid paid for 30 to 50 percent of AIDS hospitalizations in the five communities, but was not well-suited to serving AIDS patients' needs.

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