Hospital and Outpatient Health Services Utilization Among HIV-Infected Adults in Care 2000–2002
Hospital and Outpatient Health Services Utilization Among HIV-Infected Adults in Care 2000–2002
复制标题
2000-2002 年接受护理的艾滋病毒感染者的医院和门诊医疗服务利用率
DOI：
10.1097/01.mlr.0000175621.65005.c6
复制
发表时间：
2005
期刊：
影响因子：
3
通讯作者：
Richard D. Moore
中科院分区：
文献类型：
--
作者：
J. Fleishman;K. Gebo;E. Reilly;R. Conviser;W. Mathews;P. Korthuis;J. Hellinger;R. Rutstein;P. Keiser;H. Rubin;Richard D. Moore
背景：艾滋病流行病学和抗逆转录病毒治疗的快速变化可能导致最近医疗保健利用模式的变化。目的：本研究的目的是探讨社会人口学和临床相关的住院和门诊艾滋病毒相关的卫生服务利用在多个国家的样本艾滋病毒感染者。设计：从2000年、2001年和2002年的病历中收集人口统计学、临床和资源利用数据。背景：本研究在不同地理区域的11个美国HIV初级和专科护理中心进行。患者：每年，至少有一个CD 4计数和任何使用住院，门诊或急诊室服务的HIV阳性患者。2000年的样本量为13 392人，2001年为15 211人，2002年为14 403人。主要结果指标：主要结果指标为住院人数、住院总天数和每年门诊/办公室就诊人数。通过将单位成本应用于住院天数和门诊就诊次数来估计住院和门诊费用。结果：2000年（0.40）至2002年（0.35），平均每人每年的入院人数有所下降，但在多变量分析中，这种差异并不显著。在免疫抑制程度较高的患者、女性、黑人、通过吸毒获得艾滋病毒的患者、50岁及以上的患者以及接受医疗补助或医疗保险的患者中，住院率显著较高。2000年至2002年期间，年平均门诊量大幅度下降，从每人每年6.06次下降到5.66次。白人、西班牙裔、30岁及以上、接受高效抗逆转录病毒治疗（HAART）的人以及接受医疗补助或医疗保险的人的门诊利用率显著较高。2000年每名患者每月的住院费用（PPPM）估计为514美元，2001年为472美元，2002年为424美元; 2000年每名患者每月的门诊费用估计为108美元，2001年为100美元，2002年为101美元。结论：在这3年期间，尽管在某些情况下具有统计学意义，但利用率的变化并不显著。少数群体或弱势群体的住院率仍然相对较高，表明在护理方面持续存在差异。HAART患者的住院和门诊费用并不显著低于未接受HAART的患者。
Background:Rapid changes in HIV epidemiology and antiretroviral therapy may have resulted in recent changes in patterns of healthcare utilization. Objective:The objective of this study was to examine sociodemographic and clinical correlates of inpatient and outpatient HIV-related health service utilization in a multistate sample of patients with HIV. Design:Demographic, clinical, and resource utilization data were collected from medical records for 2000, 2001, and 2002. Setting:This study was conducted at 11 U.S. HIV primary and specialty care sites in different geographic regions. Patients:In each year, HIV-positive patients with at least one CD4 count and any use of inpatient, outpatient, or emergency room services. Sample sizes were 13,392 in 2000, 15,211 in 2001, and 14,403 in 2002. Main Outcome Measures:Main outcome measures were number of hospital admissions, total days in hospital, and number of outpatient clinic/office visits per year. Inpatient and outpatient costs were estimated by applying unit costs to numbers of inpatient days and outpatient visits. Results:Mean numbers of admissions per person per year decreased from 2000 (0.40) to 2002 (0.35), but this difference was not significant in multivariate analyses. Hospitalization rates were significantly higher among patients with greater immunosuppression, women, blacks, patients who acquired HIV through drug use, those 50 years of age and over, and those with Medicaid or Medicare. Mean annual outpatient visits decreased significantly between 2000 and 2002, from 6.06 to 5.66 visits per person per year. Whites, Hispanics, those 30 years of age and over, those on highly active antiretroviral therapy (HAART), and those with Medicaid or Medicare had significantly higher outpatient utilization. Inpatient costs per patient per month (PPPM) were estimated to be $514 in 2000, $472 in 2001, and $424 in 2002; outpatient costs PPPM were estimated at $108 in 2000, $100 in 2001, and $101 in 2002. Conclusion:Changes in utilization over this 3-year period, although statistically significant in some cases, were not substantial. Hospitalization rates remain relatively high among minority or disadvantaged groups, suggesting persistent disparities in care. Combined inpatient and outpatient costs for patients on HAART were not significantly lower than for patients not on HAART.
影响因子：
158.5
作者：
Freedberg, KA;Losina, E;Goldie, SJ
通讯作者：
Goldie, SJ
马里兰州城市艾滋病毒感染者群体中推进免疫抑制的医疗补助费用。
DOI：
10.1097/00042560-199703010-00005
发表时间：
1997
期刊：
Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association
影响因子：
--
作者：
Moore,RD;Chaisson,RE
通讯作者：
Chaisson,RE
影响因子：
3.8
作者：
Moore, RD;Chaisson, RE
通讯作者：
Chaisson, RE