HIV hospital readmissions decreased between 2005 and 2018
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Key takeaways:
- Thirty-day hospital readmissions among people in HIV care decreased between 2005 and 2018.
- Thirty-day readmissions remained highest for patients hospitalized for an AIDS-defining condition.
Thirty-day hospital readmissions decreased among patients in HIV care in the United States and Canada from 2005 to 2018, researchers reported.
“Prior studies had shown that hospital readmissions are frequent for people living with HIV. However, the most recent large studies used data from 2011 or earlier,” Thibaut Davy-Mendez, PhD, MSPH, assistant professor in the division of infectious diseases at the University of North Carolina Chapel Hill, told Healio.
“There had been important changes in HIV care since then, notably the expanded use of effective antiretroviral therapy leading to greater viral suppression rates and higher CD4 counts among people with HIV. On the other hand, people with HIV are aging and experiencing more comorbidities,” he said.
Davy-Mendez explained that 30-day readmission rates among all people have become a “prominent hospital quality metric,” and because of this, they aimed to determine whether and how readmission rates had changed among people with HIV in recent years.
To do so, the researchers assessed patients with HIV in six cohorts of the North American AIDS Cohort Collaboration on Research and Design with reported readmissions between 2005 and 2018. According to the study, they used linear risk regression to estimate calendar trends in 30-day readmissions and adjusted these trends for demographics, CD4 count, AIDS history, virologic suppression and cohort.
In total, researchers assessed 20,189 hospitalizations among 8,823 people with HIV.
Results of the study showed that 30-day hospital readmissions among people with HIV receiving care decreased from 20.1% (95% CI, 17.9%-22.3%) in 2005 to 16.3% (95% CI, 14.1%-18.5%) in 2018.
After adjusting for demographic and clinical factors, those hospitalized in 2018 vs. those hospitalized in 2005 were older on average (54 vs. 44 years), had a higher CD4 count (469 vs. 274 cells/L), and had higher rates of virologic suppression (83% vs. 49%).
When researchers analyzed reasons for readmission, the study demonstrated that readmissions “significantly decreased” for patients hospitalized for cardiovascular conditions and for those with psychiatric conditions (–0.47% change per year and –0.46% change per year, respectively). They added, though, that 30-day readmissions remained highest for patients hospitalized for an AIDS-defining condition (26%).
“Although readmissions have decreased for people with HIV, they remain high compared to the general population, and continued efforts are needed to further reduce readmissions among hospitalized patients with HIV,” Davy-Mendez said.
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