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. 2018 Jul/Aug;133(4):442-451.
doi: 10.1177/0033354918777254. Epub 2018 Jun 18.

Hospitalization Trends and Comorbidities Among People With HIV/AIDS Compared With the Overall Hospitalized Population, Illinois, 2008-2014

Livia Navon  1
Affiliations

Hospitalization Trends and Comorbidities Among People With HIV/AIDS Compared With the Overall Hospitalized Population, Illinois, 2008-2014

Livia Navon. Public Health Rep. 2018 Jul/Aug.

Abstract

Objectives: To understand trends in health care use among people living with HIV/AIDS (PLWHA), this study compared trends in hospitalization rates, comorbidities, and hospital death rates of hospitalized PLWHA with the overall hospitalized population in Illinois during 2008-2014.

Methods: This study identified principal hospitalizations (the principal discharge diagnosis coded with an HIV-related billing code) and secondary HIV hospitalizations (a non-principal discharge diagnosis coded with an HIV-related billing code) from 2008-2014 Illinois hospital discharge data. Hospitalization rates among PLWHA were calculated using prevalence data from the Illinois Electronic HIV/AIDS Registry; US Census population estimates were used to calculate overall Illinois hospitalization rates. Joinpoint regression analysis was used to assess trends overall and among demographic subgroups. Comorbidities and discharge status for all hospitalizations were identified.

Results: In 2014, the hospitalization rate was 2.2 times higher among PLWHA than among the overall Illinois hospitalized population. From 2008 to 2014, principal HIV hospitalization rates per 1000 PLWHA decreased by 48% (from 71 to 37) and secondary HIV hospitalization rates declined by 26% (from 296 to 218). The decline in the principal HIV hospitalization rate was steepest from 2008 to 2011 (annual percentage change = -16.0%; P = .003). Mood disorders, substance-related diagnoses, and schizophrenia accounted for 18% to 22% of principal hospitalizations among PLWHA compared with 7% to 8% of overall Illinois hospitalizations. Hepatitis as a comorbidity was more common among hospitalized PLWHA (18%-22%) than among the overall Illinois hospitalized population (1.4%-1.5%). Hospitalized PLWHA were 3 times more likely than the overall Illinois hospitalized population to die while hospitalized.

Conclusions: HIV hospitalizations are largely preventable with appropriate treatment and adherence. Additional efforts to improve retention in HIV care that address comorbidities of PLWHA are needed.

Keywords: HIV/AIDS; comorbidities; disparities; hospitalization; mental health.

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Conflict of interest statement

Declaration of Conflicting Interests: The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Rates for principal HIV hospitalizations (n = 10 980), secondary HIV hospitalizations (n = 59 987), and overall hospitalizations (n = 11.2 million), by year, Illinois, 2008-2014. Principal HIV hospitalizations are hospitalizations with a principal diagnostic code (ie, the first-listed diagnosis) with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) HIV codes 042, 079.53, or 795.71 indicating that a patient was hospitalized because of a complication of HIV infection. Secondary HIV hospitalizations are hospitalizations with an ICD-9-CM HIV code as any nonprincipal diagnostic code. Data sources: Illinois Department of Public Health, hospital discharge data; Illinois HIV surveillance data; and US Census population estimates, 2008-2014.
Figure 2.
Figure 2.
Rates for principal hospitalizations (n = 10 980) among people living with HIV/AIDS, by race/ethnicity, sex, age group, and year, Illinois, 2008-2014. Excluded were 332 hospitalizations for which the patient’s ZIP code indicated the patient did not reside in Illinois. Data sources: Illinois Department of Public Health hospital discharge data; Illinois HIV surveillance data; and US Census population estimates, 2008-2014.
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References

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