ACSUSAssociation for Canadian Studies in the United States
ACSUSAIDS Cost and Services Utilization Survey
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The findings from ACSUS were buttressed by other early studies.
In their study of 606 Medicaid patients (380 men and 226 women) treated at the Johns Hopkins University AIDS Service between July 1992 and June 1995, Moore and Chaisson stated that, "The higher payment that we found in men compared with women in our bivariate analyses is consistent with results from the ACSUS and the New York State Study, both of which indicated that women had lower hospital costs than men" (Moore and Chaisson 1997, p.
Although the ACSUS was a most important precursor to HCSUS, it represents an earlier era of HIV treatment and was limited by the lack of a representative sample of the HIV-positive population under treatment in the United States.
Moore and Chaisson (1997), in their study of Maryland Medicaid recipients, found that it was 7 percent more expensive to treat persons with AIDS who were not white, and data from ACSUS indicated that white persons with AIDS were 8 percent less likely to be hospitalized than persons who were not white (Hellinger, 1993b).
In the ACSUS, a series of six personal interviews were conducted over an 18-month period, from 1991 to 1992.
12) For information about the ACSUS survey, refer to Berk, Maffeo, and Schur (1993).
Lancaster and Intrator (1998) used a transition model to analyze frequency of hospitalization jointly with survival time but did not model length of stay; they used ACSUS data, which do not include the crucial period at the end of life.
Prior analyses of ACSUS data have shown that health status variables, such as ADL limitations, interact with enabling variables, such as insurance coverage, to affect utilization of medical care (Fleishman, Hsia, and Hellinger 1994).
This issue of Health Services Research presents some of the first reports of findings from ACSUS.
Unlike many prior studies, ACSUS obtained a large, sociodemographically diverse sample, including people at different stages of HIV infection, from ten communities across the United States, and the data pertain to utilization patterns as of 1991-1992.
The contract to develop and conduct the ACSUS was awarded to Westat, Inc.
The ACSUS sample was selected from 26 sites (hospitals, clinics, and physician offices) in ten cities chosen from the 25 cities with the most AIDS cases.