Abstract
Objective: Hospital readmissions impose considerable physical and psychological hardships on patients and represent a high, but possibly preventable, cost for insurers and hospitals alike. The objective of this study was to identify patient characteristics associated with 30-day readmission among persons living with HIV/AIDS (PLWH) using a statewide administrative database and to characterize the movement of patients between facilities. Design: Retrospective cohort analysis of HIV-infected individuals in New York State using a comprehensive, all-payer database. Setting: All hospitals in New York State. Participants: HIV-infected adults admitted to a medical service in 2012. PLWH identified using International Classification of Disease (ICD)-9 diagnosis codes 042 and V08. Results: Of 23,544 index hospitalizations, 21.8% (5121) resulted in readmission. Multivariable predictors of readmission included insurance status, housing instability, psychoses, multiple comorbid chronic conditions, substance use, and past inpatient and emergency department visits. Over 30% of readmissions occurred at a different facility than that of the initial hospitalization. Conclusion: A number of patient characteristics were independently associated with hospital readmission within 30 days. Behavioral health disorders and comorbid conditions may be the strongest predictors of readmission in PLWH. Readmissions, especially those in urban areas, often result in fragmented care which may compromise the quality of care and result in harmful discontinuity of medical treatment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 407-412 |
| Number of pages | 6 |
| Journal | Journal of Acquired Immune Deficiency Syndromes |
| Volume | 71 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2016 |
| Externally published | Yes |
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Keywords
- AIDS
- Fragmented hospital use
- HIV
- Quality care
- Readmission
ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)
Cite this
Readmissions in HIV-infected inpatients : A large cohort analysis. / Feller, Daniel J.; Akiyama, Matthew J.; Gordon, Peter; Agins, Bruce D.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 71, No. 4, 2016, p. 407-412.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Readmissions in HIV-infected inpatients
T2 - A large cohort analysis
AU - Feller, Daniel J.
AU - Akiyama, Matthew J.
AU - Gordon, Peter
AU - Agins, Bruce D.
PY - 2016
Y1 - 2016
N2 - Objective: Hospital readmissions impose considerable physical and psychological hardships on patients and represent a high, but possibly preventable, cost for insurers and hospitals alike. The objective of this study was to identify patient characteristics associated with 30-day readmission among persons living with HIV/AIDS (PLWH) using a statewide administrative database and to characterize the movement of patients between facilities. Design: Retrospective cohort analysis of HIV-infected individuals in New York State using a comprehensive, all-payer database. Setting: All hospitals in New York State. Participants: HIV-infected adults admitted to a medical service in 2012. PLWH identified using International Classification of Disease (ICD)-9 diagnosis codes 042 and V08. Results: Of 23,544 index hospitalizations, 21.8% (5121) resulted in readmission. Multivariable predictors of readmission included insurance status, housing instability, psychoses, multiple comorbid chronic conditions, substance use, and past inpatient and emergency department visits. Over 30% of readmissions occurred at a different facility than that of the initial hospitalization. Conclusion: A number of patient characteristics were independently associated with hospital readmission within 30 days. Behavioral health disorders and comorbid conditions may be the strongest predictors of readmission in PLWH. Readmissions, especially those in urban areas, often result in fragmented care which may compromise the quality of care and result in harmful discontinuity of medical treatment.
AB - Objective: Hospital readmissions impose considerable physical and psychological hardships on patients and represent a high, but possibly preventable, cost for insurers and hospitals alike. The objective of this study was to identify patient characteristics associated with 30-day readmission among persons living with HIV/AIDS (PLWH) using a statewide administrative database and to characterize the movement of patients between facilities. Design: Retrospective cohort analysis of HIV-infected individuals in New York State using a comprehensive, all-payer database. Setting: All hospitals in New York State. Participants: HIV-infected adults admitted to a medical service in 2012. PLWH identified using International Classification of Disease (ICD)-9 diagnosis codes 042 and V08. Results: Of 23,544 index hospitalizations, 21.8% (5121) resulted in readmission. Multivariable predictors of readmission included insurance status, housing instability, psychoses, multiple comorbid chronic conditions, substance use, and past inpatient and emergency department visits. Over 30% of readmissions occurred at a different facility than that of the initial hospitalization. Conclusion: A number of patient characteristics were independently associated with hospital readmission within 30 days. Behavioral health disorders and comorbid conditions may be the strongest predictors of readmission in PLWH. Readmissions, especially those in urban areas, often result in fragmented care which may compromise the quality of care and result in harmful discontinuity of medical treatment.
KW - AIDS
KW - Fragmented hospital use
KW - HIV
KW - Quality care
KW - Readmission
UR - http://www.scopus.com/inward/record.url?scp=84960238853&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84960238853&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000000876
DO - 10.1097/QAI.0000000000000876
M3 - Article
VL - 71
SP - 407
EP - 412
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
SN - 1525-4135
IS - 4
ER -