NEARLY 1 IN 5 US HIV PATIENTS IN HOSPITAL READMITTED WITHIN 30 DAYS

NEARLY 1 IN 5 US HIV PATIENTS IN HOSPITAL READMITTED WITHIN 30 DAYS

Author: Mark Mascolini



27 September 2013
Almost 20% of HIV-positive people discharged from the hospital had to be readmitted within 30 days of discharge, according to results of a large nine-clinic study.

Hospital readmission within 30 days is becoming a quality-of-care indicator. Because there is little information on hospital readmissions among people with HIV infection, HIV Research Network investigators undertook this study of a prospective multicenter observational cohort in care at one of nine US HIV clinics in the years 2005-2010.

The study involved 11,651 HIV-positive people with an initial hospital admission. The 30-day readmission rate in that group was 19.3%. The 19.3% readmission rate exceeds the 13.3% rate reported for the general population of 18- to 64-year-olds in the United States.

AIDS-defining illnesses accounted for 9.6% of initial hospital admissions and non-AIDS infections for 26.4%. Readmission rates for AIDS-defining illnesses and non-AIDS infections were 26.2% and 16.6%.

Having a CD4 count below 50 cells/μL versus above 350 cells/μL raised chances of hospital readmission 80% (adjusted odds ratio 1.80, 95% confidence interval [CI] 1.53 to 2.11). An initial hospital stay of 9 days or more versus 1 to 3 days raised chances of readmission 77% (adjusted odds ratio 1.77, 95% CI 1.53 to 2.04). Having an AIDS-defining infection also independently raised chances of readmission.

Having an outpatient follow-up clinic visit after discharge from the initial hospital admission did not lower readmission risk (adjusted hazard ratio 0.98, 95% CI 0.88 to 1.08).

“Policymakers may consider the impact of HIV when estimating expected readmissions for a hospital or region,” the researchers suggest.

“Preventing or recovering from severe immune dysfunction,” they propose, “may be the most important factor to reducing readmissions.”

Source: Stephen A. Berry, John A. Fleishman, Baligh R. Yehia, P. Todd Korthuis, Allison L. Agwu, Richard D. Moore, Kelly A. Gebo. Thirty-day hospital readmission rate among adults living with HIV. AIDS. 2013; 27: 2059-2068.
For the study abstract

(Downloading the complete article requires a subscription to AIDS or an online payment; the abstract is free.)

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