Burden of HIV on Hospitals in USA: Analysis of Nationwide Emergency Department Sample Data
Background: Medical management for the HIV disease has made tremendous progress in the last decade with introduction of newer class of drugs and availability of combination pills making it possible to treat resistant and noncompliant patients respectively. However, the extent of burden of HIV on US hospitals is still not known. This study was done to determine the burden of HIV disease on USA healthcare and analyze the trend of disease from 2006-2011.
Methods: We queried Nationwide Emergency Department Sample data for all the patient visits with first listed diagnosis of HIV using Clinical classification software code 5, corresponding to International Classification Code 9 codes of 042, 042.0, 042.1, 042.2, 042.9, 043.0, 043.1, 043.2, 043.3, 043.9, 044.0, 044.9, 079.53, 279.10, 279.19, 795.71, 79.58 and V08. Data was extracted for the years 2006 to 2011. Admission rate to hospitals during Emergency Department (ED) visits and in-hospital mortality for admitted patients was calculated. SPSS was used for statistical analysis and p<0.05 considered significant for the purpose of this study.
Results: We identified total of 379,332 ED visits with first listed diagnosis of HIV from 2006-11, with average admission rate of 78.36% and average in-hospital mortality during stay of 6.66%. Rate of patient visits to ED for first listed diagnosis of HIV decreased from 25.4 per 100,000 persons in 2006 to 15.7 per 100,000 in 2011. Hospital admission rates for ED visits declined from 81.28% to 72.25% (p<0.05). In-hospital mortality for these admissions declined from 7.03% to 6.09% (p<0.05)
Conclusion: Our study reveals that although ER visits, hospitalization and in-hospital mortality from HIV has decreased significantly from 2006-11 but still rate of hospitalization remains high with 3 out of 4 patients being admitted to the hospital with 6% mortality compared to national average of in-hospital mortality of 0.6% for Diabetes mellitus and 5% for myocardial infarction. It indicates there is still large unmet need for interventions in managements of HIV to reduce burden on healthcare.
P. Mahajan, None
G. P. Garcha, None
D. Garg, None