Methods: Hospitalizations associated with HIV as the primary ICD-9 code (042) were identified in the 2012 National Inpatient Sample (NIS) and correlated with age, gender, inpatient length of stay, race, total cost, payment methods & location.
Results: Of the 7,296,968 admissions in the 2012 NIS, 7,711 were associated with HIV listed as the primary diagnosis (prevalence 0.106%). There was a higher prevalence of male patients (5238) compared to female (2473) patients (67.93% vs. 32.07%). The mean age was 44 years (SD 11.7) and median age was 45 years, with a range of ages 0-85. The average length of stay for all patients was 4.91 days. Most patients were African American (52.5%), Caucasian (25.1%) or Hispanic (14.6%). The majority of admissions for HIV as the primary diagnosis were in the South Atlantic region of the United States (31.7%), followed by the Mid-Atlantic (19.6%) & West South Central regions. Those admitted with HIV as their primary diagnosis tended to use Medicaid as their first payment option (41.0%), followed by Medicare (24.5%), private insurance (15.6%) & self pay (13.6%). Among these patients, the majority of patients had a mean income based on zip code of $1-38,999 (42.1%), followed by $39,000-$47,999 (20.1%). The average total cost for an admission was $70,234, and the median total charge was $36,936.
Conclusion: Patients admitted for HIV as their primary diagnosis were more often male, African American, from the lowest income bracket by zip code, more likely to use Medicaid over other payment options, and most often in the South Atlantic United States. The average total cost of a hospitalization for HIV in 2012 was $70,234 per patient, representing a significant economic burden.