1498. Comparing utilization of inpatient services and hospital outcomes for patients with HIV, HCV, or HIV/HCV
Session: Poster Abstract Session: HIV and Co-infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDWeek 2013 Poster FINAL.pdf (459.8 kB)
  • Background: Few studies have compared hospital outcomes for patients with human immunodeficiency virus (HIV), hepatitis C virus (HCV), or HIV/HCV coinfection. Thus, the impact of infection type on the U.S. inpatient health care delivery system is relatively unknown. This study compared utilization of inpatient services and outcomes over 15 years in hospitalized patients with HIV, HCV, or HIV/HCV.

    Methods: Data from the 1996-2010 National Hospital Discharge Surveys (NHDS) were used for this study. Hospitalizations with primary or secondary ICD-9-CM codes for HIV or HCV were included. Codes 042, V08, 079.53 were used for HIV infection and codes 070.41, 070.44, 070.51, 070.54, 070.70, 070.71 for HCV infection. Coinfection hospitalizations included those with both HIV and HCV codes. Patients <15 years of age at time of hospitalization were excluded from analysis. Select patient demographics and facility characteristics were compared by infection type (HIV, HCV, HIV/HCV). Hospital-related measurements included procedural interventions (determined by procedure codes), average hospital length of stay (LOS), and discharge status. Chi-square tests were used for analysis of nominal data and Kruskal-Wallis tests were used to compare LOS. NHDS survey weights were incorporated to generate population-level estimates.

    Results: 6.6 million hospitalizations for patients with HIV (39%), HCV (56%), or HIV/HCV (5%) were included. Both the HIV and HIV/HCV cohorts were comprised of mostly black patients and were younger in age compared to the HCV cohort (p<0.001). Most patients were admitted to nonprofit hospitals. The following procedural interventions varied significantly (p<0.001) across the three cohorts (HIV, HCV, HIV/HCV): lumbar puncture (7%, 1%, 5%), bronchoscopy (5%, 1%, 3%), and upper gastrointestinal endoscopy (4%, 6%, 4%). Median LOS (interquartile range) decreased significantly for all cohorts from 1996 to 2010: HIV cohort, 6 days (3-10) to 4 days (3-8); HCV cohort, 5 days (3-9) to 4 days (2-6); HIV/HCV cohort, 6 days (4-11) to 4 days (2-7). The majority of all patients were discharged home.

    Conclusion: While improvements in hospital outcomes were noted in all cohorts, the rate of improvement and utilization of inpatient services varied differentially by infection type.

    Christine U. Oramasionwu, PharmD, MSc, PhD, Terence Johnson, BS and Joshua Toliver, BA, PharmD Candidate, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC

    Disclosures:

    C. U. Oramasionwu, University of North Carolina at Chapel Hill: Grant Investigator, Research grant

    T. Johnson, None

    J. Toliver, None

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