Associations between outpatient and inpatient service use among persons with HIV infection: a positive or negative relationship?

Health Services Research
John A FleishmanKelly A Gebo

Abstract

To examine the prospective association between frequency of outpatient visits and subsequent inpatient admissions. Medical record data on 13,942 patients with HIV infection seen in 10 HIV speciality care sites across the United States. This observational study followed a cohort of HIV-infected patients who were in care in the first half of 2001. Numbers of inpatient admissions and outpatient visits were calculated for each patient for each 3-month period, from 2001 through 2004. Negative binomial and logistic regression analyses using random-effects models examined the effects of inpatient admissions and outpatient visits in the previous period on inpatient and outpatient service utilization, controlling for background characteristics and HIV disease stage. For 3-month periods, between 5 and 9 percent of patients had an inpatient admission. The linear association between number of outpatient visits and any inpatient admission in the subsequent period was positive (adjusted odds ratio=1.05; 95 percent confidence interval [CI]=1.04, 1.06). However, patients with zero prior outpatient visits had significantly greater admission rates than those with one prior visit. Hospitalization rates were also higher among those with a prior ho...Continue Reading

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Citations

Apr 18, 2009·American Journal of Public Health·Lisa R MetschCarlos del Rio
Jul 15, 2015·AIDS Patient Care and STDs·Ank E NijhawanMamta K Jain
Sep 12, 2018·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Stephanie ParentLianping Ti

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