2181. HIV and Comorbid Behavioral Health Conditions: Evidence Supporting an Interprofessional Approach
Session: Poster Abstract Session: HIV Psychiatry
Saturday, October 29, 2016
Room: Poster Hall
Background: Studies demonstrate the prevalence of comorbid HIV and depression and/or anxiety is as high as 58%, and substance abuse disorder comorbidity lifetime prevalence is estimated at greater than 50%. In response to these psychosocial complexities of HIV’s disease manifestation, healthcare organizations and funding institutions are increasingly utilizing an interprofessional healthcare workforce to treat individuals infected with HIV. However, little is known regarding the role of mental health professionals on healthcare utilization patterns of individuals with HIV.

Methods: Presented is a retrospective, cross-sectional study of a nationally representative sample of individuals with employer sponsored healthcare plans from 2009-2013 held by the Health Care Cost Institute. A total of 69,434 individuals with HIV were included in the analysis. The primary measured outcomes included annual ED visits, annual outpatient visits, and annual inpatient admissions. Independent measures included the provision of care by a mental health professional.

Results: Among patients with HIV and depression, anxiety, or substance abuse disorder, results demonstrate varied findings associated with utilization patterns with the receipt of care from a mental health professional. The mean number of annual ED visits decreased from 0.31 visits to 0.17 visits when the patient saw a psychologist (p≤0.0001), and to 0.23 annual ED visits after seeing a psychiatrist (p≤0.0001). Annual inpatient admissions decreased from 0.19 admissions to 0.14 admissions after seeing a psychologist (p=0.0027) and no significant change in admission was demonstrated among patients who saw a psychiatrist.

Conclusion: The provision of services by a mental health professional among HIV patients with comorbid depression, anxiety and/or substance abuse disorder is associated with a significant reduction in healthcare utilization, including annual ED visits and inpatient hospitalizations. These findings support interprofessional efforts among HIV healthcare teams and suggest additional attention is warranted to promote interprofessional training and discussions around reimbursement mechanisms for whole-person care.

Alexander Enurah, MD, Internal Medicine, University Of Colorado, Aurora, CO, Lynn Vanderwielen, PhD, MPH, Mental Health Center of Denver, Denver, CO, Kellie Hawkins, MD, MPH, Infectious Diseases, University of Colorado Denver, Aurora, CO, Molly Nowels, MS, Family Medicine, University of Colorado, Aurora, CO and Edward Gardner, MD, Denver Health and Hospital, Denver, CO

Disclosures:

A. Enurah, None

L. Vanderwielen, None

K. Hawkins, None

M. Nowels, None

E. Gardner, None

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