Recent trends in HIV-related inpatient admissions 1996-2000 - A 7-state study
Recent trends in HIV-related inpatient admissions 1996-2000 - A 7-state study
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DOI：
10.1097/00126334-200309010-00015
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发表时间：
2003-09-01
影响因子：
3.6
通讯作者：
Hellinger, FH
中科院分区：
文献类型：
--
作者：
Fleishman, JA;Hellinger, FH
背景和目的：在高效抗逆转录病毒疗法(HAART)推广后，HIV相关住院患者的使用率立即下降，但一些研究表明，入院率最近可能已经开始上升。使用7个州的综合出院数据，本研究检查了1996至2000年间HIV相关住院患者和住院时间(LOS)的趋势。方法：我们根据ICD-9-CM诊断代码确定了从042到044范围内的HIV相关住院。分析评估了随时间变化的不同模式，取决于州、性别、种族/民族和保险。结果：与艾滋病毒相关的住院人数总体上每年都在下降，但最近下降的速度有所减少。洛杉矶住院患者的趋势也是如此。白人男性患者和私人保险患者的入院人数显示出最大的下降和最小的趋势持平。黑人男性的艾滋病毒入院人数占总入院人数的比例最高，白人女性的比例最低。与1993年至1996年期间相比，医疗保险覆盖的HIV住院人数比例高于私人保险入院率。结论：尽管没有实质性证据表明这一时期艾滋病毒相关住院人数普遍增加，但结果表明，近年来与HIV相关的住院人数呈持平趋势。在住院利用方面，种族/民族差异依然存在。有必要进一步分析治疗失败或HAART相关并发症对艾滋病毒入院的影响。
Background and Objectives: HIV-related inpatient utilization declined immediately after the diffusion of highly active antiretroviral therapy (HAART), but some studies suggest that admission rates may have recently begun to increase. Using comprehensive hospital discharge data from 7 states, this study examines trends in HIV-related inpatient admissions and length of stay (LOS) from 1996 through 2000.Methods: We identified HIV-related admissions by ICD-9-CM diagnosis codes in the range from 042 to 044. Analyses assessed differential patterns of change over time, depending on state, gender, race/ethnicity, and insurance.Results: HIV-related inpatient admissions generally declined each year, but the rate of decline diminished recently. A similar pattern held for trends in inpatient LOS. Admissions for white male patients and for patients with private insurance showed the greatest decreases and the least leveling of the trend. The proportion of HIV admissions to total admissions was highest for black men and lowest for white women. In contrast to the period from 1993 through 1996, the proportion of HIV admissions covered by Medicare was greater than the rate of privately insured admissions.Conclusions: Although there is no substantial evidence for widespread increases in admissions during this period, results suggest that the trend in HIV-related hospital admissions is level in recent years. Racial/ethnic disparities in inpatient utilization persist. Further analysis of the impact of treatment failure or HAART-related complications on HIV admissions is warranted.