Predicting the future of the AIDS epidemic and its consequences for the health care system of New York City

The point of this exercise is not to predict precisely the exact number of AIDS cases that will occur in any particular year. Rather, it is our aim to utilize existing data to develop a plausible scenario of the demand that this epidemic may place on the health care system of New York City in the very near future. To ignore the possibilities inherent in the empirical evidence currently available is to court a societal calamity even greater than the one already perceived. Even now, in the early phase of this epidemic, when HIV infected people occupy only 4.5% of the City's total of hospital beds, a set of emerging distortions and difficulties already threaten the integrity of the City's hospital system. A similar pattern is occurring in other cities with equivalent case rates, e.g. Newark and San Francisco. Innovation, particularly in a system so large and well established as New York's metropolitan health care establishment, which can protect the existing system while still meeting the challenge of AIDS, will be difficult and time consuming at best. But time is short, the need is great and is likely to grow rapidly.