{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:07:39Z","timestamp":1788934059757,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the expansion of antiretroviral therapy, human immunodeficiency virus\/acquired immunodeficiency syndrome (HIV\/AIDS) has increasingly become a manageable chronic condition. However, late presentation, opportunistic infections, and critical care can still generate substantial inpatient costs. Mean-based analyses may obscure upper-tail cost concentration. This study quantified HIV\/AIDS inpatient cost concentration and resource-use profiles of high-cost hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed HIV\/AIDS hospitalizations at a tertiary infectious disease hospital between 1 January 2019 and 31 December 2024. High-cost hospitalizations were defined as total inpatient costs at or above the 90th percentile. Cost concentration was assessed using the Lorenz curve, Gini coefficient, and expenditure shares of the top 5 and 10%. Multivariable logistic regression identified factors associated with high-cost hospitalization. Conditional quantile regression examined associations between medical resource-use intensity and costs across quantiles; recentered influence function unconditional 90th-percentile regression was used as a supplementary analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3,240 hospitalizations, the 90th-percentile threshold was RMB 62,683.41. The top 5 and 10% accounted for 23.49 and 35.97% of total inpatient costs; the Gini coefficient was 0.481. Compared with low resource-use intensity, moderate and high resource-use intensity were associated with high-cost hospitalization, with adjusted odds ratios of 18.27 (95% CI, 4.41\u201375.70) and 90.62 (95% CI, 21.94\u2013374.34), respectively. Prolonged length of stay, a greater number of coded opportunistic or AIDS-defining conditions, and non-local care seeking were also associated with high-cost hospitalization. The estimated cost difference associated with high resource-use intensity was numerically larger at higher cost quantiles, ranging from RMB 18,261.89 at the 25th percentile to RMB 60,178.15 at the 90th percentile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this single-center study conducted at a tertiary infectious disease hospital in China, HIV\/AIDS inpatient costs were concentrated in a small proportion of high-cost hospitalizations. High resource-use intensity, prolonged stay, and greater coded disease burden characterized high-cost cases, especially in the upper tail. These findings highlight the value of distributional cost analysis for identifying high-resource-use hospitalizations and informing complex case management and hospital resource planning in HIV\/AIDS care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1935687","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:59:07Z","timestamp":1788933547000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost concentration and resource-use intensity in high-cost HIV\/AIDS hospitalizations: evidence from a tertiary infectious disease hospital cohort in China"],"prefix":"10.3389","volume":"14","author":[{"given":"Di","family":"Shen","sequence":"first","affiliation":[{"name":"School of Management, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Management, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Insurance Office, Beijing Ditan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiduo","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Management, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengfan","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Management, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref1","volume-title":"The path that ends AIDS: UNAIDS Global AIDS Update 2023","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"87","DOI":"10.2989\/16085906.2025.2577377","article-title":"Universal health service coverage under threat? 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