Projecting the Impact of Aids on Hospitals

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Abstract
Prologue: In the context of the acquired immunodeficiency syndrome (AIDS) epidemic, a recent Washington Post editorial stated that “no hospital wants to shrink from the sick, but every hospital wants to protect its staff” Faced with these twin objectives, hospitals—the front line of the battle against AIDS—must meet moral and philosophical questions head on. In “balancing the rights and needs of the sick against [those] of the society at large,” the Post editorial continued, hospitals must resist the “panicky and demagogical responses” that the AIDS epidemic has provoked. And they must do so in a climate in which cost estimates and prevalence projections are constantly revised upward. In this article, Jesse Green and his colleagues at the New York University (NYU) Medical Center assess hospitals reactions to the AIDS crisis. They look at practical ways hospitals have responded to the disease's impact on staffing and financing patterns. Green, who is currently director of health services research at the NYU Medical Center, holds a doctorate in philosophy from the University of Rochester in New York. He served as a consultant to the Institute of Medicine's task force that prepared its landmark report, Confronting AIDS. Madeleine Singer, with a master of public health degree from the Yale University School of Medicine, is a research analyst at the NYU Medical Center. Neil Wintfeld holds a doctorate in policy analysis-quantitative methods from the University of Rochester and is a senior research analyst at the NYU Medical Center. Kevin Schulman, a medical student at NYU and a master of business administration candidate from the Wharton School in Philadelphia, was a research associate at the NYU Medical Center at the time the study was completed. Leigh Passman, a trainee in the NYU Medical Scientists' Training Program at the time of the study, is a resident in internal medicine at the University of California, Los Angeles.

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