Hospitalization rates have declined over 5 years for patients with HIV infection, but disparities still exist
Since the introduction of highly active antiretroviral therapy, the annual rate of hospitalizations has declined consistently for patients infected with HIV, according to a new study. Nevertheless, women, blacks, patients infected through intravenous drug use (IDU), and older patients are still hospitalized more often than other patients with HIV. The annual rate of inpatient hospitalizations for adult patients with HIV decreased from 35 per 100 persons in 2002 to 27 per 100 persons in 2007. In 2002, 19.3 percent of patients had one or more hospital admissions, dropping to 14.8 percent by 2007. The percentage of patients hospitalized more than once during the year fell from 7.8 in 2002 to 5.4 in 2007.
Over the study period, hospitalization rates were 23 percent higher among women than men, 2.5- to 4.6-fold higher among patients with lower CD4 lymphocyte cell counts (indicating greater HIV disease progression), and 45 percent higher for patients over 50 years old or who were infected through IDU. Patients covered by Medicare, Medicaid, or a combination of the two were 2.2- to 2.4-fold more likely to be hospitalized than patients with private insurance. The mean number of inpatient days for those hospitalized was more stable: 13.2 days in 2000 and 13.1 days in 2007. Again, women, patients 50 years old or older, black and Hispanic patients, and intravenous drug users had more inpatient days per year than other patients with HIV.
The study involved 10 HIV clinical care sites that are part of the HIV Research Network. De-identified data were collected from the beginning of 2002 through the end of 2007 from approximately 29,000 patients over age 18 years with HIV infection. Among these patients, 10,097 were hospitalized at least once during the study period, for a total of 15,156 hospitalizations. The study was funded in part by the Agency for Healthcare Research and Quality (AHRQ Contract No. 290-01-0012).
More details are in "Inpatient health services utilization among HIV-infected adult patients in care 2002-2007," by Baligh R. Yehia, M.D., John A. Fleishman, Ph.D., Perrin L. Hicks, M.P.H., and others in the March 1, 2010, Journal of Acquired Immune Deficiency Syndrome 53(3), pp. 397-404. Reprints (AHRQ Publication No. 10-R046) are available from the AHRQ Publications Clearinghouse.
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