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. 2023 Jan;64(1):93-102.
doi: 10.1016/j.jemermed.2022.10.020. Epub 2023 Jan 15.

Characteristics of California Emergency Departments in Centers for Disease Control and Prevention-Designated HIV Priority Counties

Christopher L Bennett  1 , Carson E Clay  2 , Khairul A Siddiqi  3 , Bankole A Olatosi  4 , Julie Parsonnet  5 , Jr Carlos A Camargo  6
Affiliations

Characteristics of California Emergency Departments in Centers for Disease Control and Prevention-Designated HIV Priority Counties

Christopher L Bennett et al. J Emerg Med. 2023 Jan.

Abstract

Background: Refocused national HIV testing initiatives include a geographic focus.

Objective: Using a geographic focus, we sought to identify which emergency departments (EDs) might be the most efficient targets for future HIV testing efforts, using California as an example.

Methods: Retrospective analysis of California EDs, emergency physicians, and patients served, along with county-level estimates of HIV prevalence and proportion of the population living in poverty. Emphasis was placed on characterizing EDs affiliated with teaching hospitals and those located in Centers for Disease Control (CDC) and Prevention HIV priority counties.

Results: Of the 320 EDs studied, 178 were in priority counties, 29 were affiliated with teaching hospitals, and 24 had both characteristics. Of the 12,869,889 ED visits included, 61.8% occurred in priority counties, 14.7% in EDs affiliated with teaching hospitals, and 12.0% in EDs with both characteristics. The subset of EDs in priority counties with teaching hospital affiliations (compared with priority and nonpriority county ED groups without a teaching hospital affiliation) had higher overall median visit volumes and higher proportions of visits by at-risk and CDC-targeted populations (e.g., individuals who were homeless, those who identified as Black or African American race, and those who identified as Hispanic or Latino ethnicity, all p < 0.01).

Conclusions: EDs in priority counties affiliated with teaching hospitals are major sources of health care in California. These EDs more often serve populations disproportionately impacted by HIV. These departments are efficient targets to direct testing efforts. Increasing testing in these EDs could reduce the burden of undiagnosed HIV in California.

Keywords: CDC; California; HIV epidemic; HIV testing; emergency department.

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Figures

Figure 1:
Figure 1:. County-level Map of California Emergency Departments by County Priority Status and Teaching Hospital Affiliation
California has 8 CDC-designated priority counties (Alameda, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, and San Francisco); these counties are shaded in grey. Individual EDs in these counties are superimposed and colored according to their teaching affiliation. Abbreviations: ED (emergency departments), CDC (Centers for Disease Control and Prevention)
Figure 2:
Figure 2:. United States Map of Centers for Disease Control and Prevention HIV Priority States and Counties
Figure adopted from Centers for Disease Control and Prevention US priority jurisdictions listed in the Ending the HIV Epidemic.6,7
See this image and copyright information in PMC

References

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