A University of Arkansas researcher and her colleagues have found that secondary conditions and diseases that could become deadly significantly affect how long HIV patients stay in the hospital.
The study, which includes the charged expenses to those patients, will help hospitals and health-care providers understand the complex nature of HIV and develop new strategies for managing care for them.
"Our study will help physicians and policymakers better identify specific patient groups who may be at greater risk for HIV infection and help hospitals better plan resources," said Shengfan Zhang, assistant professor of industrial engineering.
Zhang and colleagues at North Carolina State University used data from the 2006 Nationwide Inpatient Sample to examine two critical health-care quality indicators and determine the impact of selected chronic co-morbid diseases on HIV patients. The sample was provided by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.
"Most research has focused on cost-effectiveness analysis or policy planning with respect to HIV in isolation," Zhang said. "But we know that most HIV patients have co-morbid conditions, and these individuals tend to require additional resources compared to those who have the same primary disease but no additional conditions."
The researchers studied several co-morbid conditions, including hypertension, obesity and diabetes, but focused primarily on mental disorders. Other studies have demonstrated that roughly 50 percent of all HIV patients have at least one type of mental disorder or psychiatric diagnosis, especially drug dependence or substance abuse issues.
In raw numbers, the researchers found, HIV patients were generally younger - an average of 43 years old versus almost 57 for non-HIV patients. More than 70 percent of HIV patients were admitted through the emergency department compared to about 46 percent for non-HIV patients. HIV patients also had a higher mortality rate. Nearly 7 percent died during their hospital stay.
Zhang and her colleagues found that compared to patients with other diseases and conditions, HIV patients had longer hospital stays and greater charges. If no co-morbid condition was present, having HIV increased the length of stay on average by 60 percent and total charges by 76 percent, compared to the general patient population.
For HIV patients, average length of stay was nine days, versus almost five for patients who did not have HIV. Total charges for HIV patients were significantly higher at almost $47,000 on average, compared to roughly $26,000 for the general patient population.
Isolating the HIV group, the researchers found no significant difference in length of stay for those patients who also had hypertension and obesity. Length of stay was shorter for patients with diabetes. Compared to HIV patients with no co-morbid conditions, HIV patients with hypertension, diabetes and obesity experienced no significant difference in total charges.