HIV Testing among Outpatients with Medicaid and Commercial Insurance.
HIV Testing among Outpatients with Medicaid and Commercial Insurance.
复制标题
DOI：
10.1371/journal.pone.0144965
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Branson BM
中科院分区：
文献类型：
--
作者：
Dietz PM;Van Handel M;Wang H;Peters PJ;Zhang J;Viall A;Branson BM
为了评估 2012 年医疗补助和商业保险人群中的 HIV 检测和与接受检测相关的因素。对两个数据库中的门诊和实验室索赔进行了分析：六个州的所有医疗补助索赔和其他四个州的医疗补助健康计划的所有索赔以及美国商业保险患者的大型全国便利样本。我们排除了年龄 <13 岁和 >64 岁、入组 12 个月内 <9 个月的患者、怀孕女性以及之前诊断出感染 HIV 的患者。我们使用 HIV ICD-9 代码识别了在 HIV 检测之后（而不是之前）新诊断出 HIV 的患者。 HIV 检测百分比是根据患者人口统计数据以及同一次就诊期间发生的其他检测或诊断来评估的。 2012 年期间，2,069,536 名医疗补助患者中的 89,242 名患者 (4.3%) 至少进行了一次 HIV 检测，其中 850 名 (1.0%) 接受了新的 HIV 诊断。在 27,206,804 名拥有商业保险的患者中，757,646 名患者（2.8%）至少接受过一次 HIV 检测，其中 5,884 名患者（0.8%）接受了新的 HIV 诊断。在包含 HIV 检测的就诊期间，80.2% 的医疗补助和 83.0% 的商业保险索赔还包括在同一次就诊时进行性传播感染 (STI) 和/或乙型肝炎或丙型肝炎病毒的检测或诊断。 HIV 检测主要与性传播感染或乙型肝炎或丙型肝炎筛查或诊断同时进行。我们发现几乎没有证据表明 HIV 感染的常规筛查很普遍。
To assess HIV testing and factors associated with receipt of testing among persons with Medicaid and commercial insurance during 2012. Outpatient and laboratory claims were analyzed from two databases: all Medicaid claims from six states and all claims from Medicaid health plans from four other states and a large national convenience sample of patients with commercial insurance in the United States. We excluded those aged <13 years and >64 years, enrolled <9 of the 12 months, pregnant females, and previously diagnosed with HIV. We identified patients with new HIV diagnoses that followed (did not precede) the HIV test, using HIV ICD-9 codes. HIV testing percentages were assessed by patient demographics and other tests or diagnoses that occurred during the same visit. During 2012, 89,242 of 2,069,536 patients (4.3%) with Medicaid had at least one HIV test, and 850 (1.0%) of those tested received a new HIV diagnosis. Among 27,206,804 patients with commercial insurance, 757,646 (2.8%) had at least one HIV test, and 5,884 (0.8%) of those tested received a new HIV diagnosis. During visits that included an HIV test, 80.2% of Medicaid and 83.0% of commercial insurance claims also included a test or diagnosis for a sexually transmitted infection (STI), and/or Hepatitis B or C virus at the same visit. HIV testing primarily took place concurrently with screening or diagnoses for STIs or Hepatitis B or C. We found little evidence to suggest routine screening for HIV infection was widespread.