Thirty-day hospital readmission rate among adults living with HIV
Thirty-day hospital readmission rate is receiving increasing attention as a quality-of-care indicator. The objective of this study was to determine readmission rates and to identify factors associated with readmission among persons living with HIV. Prospective multicenter observational cohort. Nine...
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| Veröffentlicht in: | AIDS (London) 2013-08, Vol.27 (13), p.2059-2068 |
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| creator | BERRY, Stephen A FLEISHMAN, John A YEHIA, Baligh R KORTHUIS, P. Todd AGWU, Allison L MOORE, Richard D GEBO, Kelly A |
| description | Thirty-day hospital readmission rate is receiving increasing attention as a quality-of-care indicator. The objective of this study was to determine readmission rates and to identify factors associated with readmission among persons living with HIV.
Prospective multicenter observational cohort.
Nine US HIV clinics affiliated through the HIV Research Network.
Patients engaged in HIV care during 2005-2010.
Readmission rate was defined as the proportion of hospitalizations followed by a readmission within 30 days. Factors in multivariate analyses included diagnostic categories, patient demographic and clinical characteristics, and having an outpatient follow-up visit.
Among 11,651 total index hospitalizations, the 30-day readmission rate was 19.3%. AIDS-defining illnesses (ADIs, 9.6% of index hospitalizations) and non-AIDS-defining infections (26.4% of index hospitalizations) had readmission rates of 26.2 and 16.6%, respectively. Factors independently associated with readmission included lower CD4 cell count [adjusted odds ratio 1.80 (1.53-2.11) for CD4 cell count |
| doi_str_mv | 10.1097/QAD.0b013e3283623d5f |
| format | Article |
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Prospective multicenter observational cohort.
Nine US HIV clinics affiliated through the HIV Research Network.
Patients engaged in HIV care during 2005-2010.
Readmission rate was defined as the proportion of hospitalizations followed by a readmission within 30 days. Factors in multivariate analyses included diagnostic categories, patient demographic and clinical characteristics, and having an outpatient follow-up visit.
Among 11,651 total index hospitalizations, the 30-day readmission rate was 19.3%. AIDS-defining illnesses (ADIs, 9.6% of index hospitalizations) and non-AIDS-defining infections (26.4% of index hospitalizations) had readmission rates of 26.2 and 16.6%, respectively. Factors independently associated with readmission included lower CD4 cell count [adjusted odds ratio 1.80 (1.53-2.11) for CD4 cell count <50 vs. ≥351 cells/μl], longer length of stay [1.77 (1.53-2.04) for ≥9 days vs. 1-3 days], and several diagnostic categories including ADI. Having an outpatient follow-up clinic visit was not associated with lower readmission risk [adjusted hazard ratio 0.98 (0.88-1.08)].
The 19.3% readmission rate exceeds the 13.3% rate reported for the general population of 18-64-year-olds. HIV providers may use the 19.3% rate as a basis of comparison. Policymakers may consider the impact of HIV when estimating expected readmissions for a hospital or region. Preventing or recovering from severe immune dysfunction may be the most important factor to reducing readmissions.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0b013e3283623d5f</identifier><identifier>PMID: 23612008</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; AIDS/HIV ; Biological and medical sciences ; Female ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Patient Readmission - statistics & numerical data ; Prospective Studies ; Risk Factors ; United States ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult</subject><ispartof>AIDS (London), 2013-08, Vol.27 (13), p.2059-2068</ispartof><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-da27baacc79e745f5aaf5fbfbcc8e185b479b3f2a94336761f2e6b891a8e8d923</citedby><cites>FETCH-LOGICAL-c471t-da27baacc79e745f5aaf5fbfbcc8e185b479b3f2a94336761f2e6b891a8e8d923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27677634$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23612008$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BERRY, Stephen A</creatorcontrib><creatorcontrib>FLEISHMAN, John A</creatorcontrib><creatorcontrib>YEHIA, Baligh R</creatorcontrib><creatorcontrib>KORTHUIS, P. Todd</creatorcontrib><creatorcontrib>AGWU, Allison L</creatorcontrib><creatorcontrib>MOORE, Richard D</creatorcontrib><creatorcontrib>GEBO, Kelly A</creatorcontrib><creatorcontrib>HIV Research Network</creatorcontrib><title>Thirty-day hospital readmission rate among adults living with HIV</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>Thirty-day hospital readmission rate is receiving increasing attention as a quality-of-care indicator. The objective of this study was to determine readmission rates and to identify factors associated with readmission among persons living with HIV.
Prospective multicenter observational cohort.
Nine US HIV clinics affiliated through the HIV Research Network.
Patients engaged in HIV care during 2005-2010.
Readmission rate was defined as the proportion of hospitalizations followed by a readmission within 30 days. Factors in multivariate analyses included diagnostic categories, patient demographic and clinical characteristics, and having an outpatient follow-up visit.
Among 11,651 total index hospitalizations, the 30-day readmission rate was 19.3%. AIDS-defining illnesses (ADIs, 9.6% of index hospitalizations) and non-AIDS-defining infections (26.4% of index hospitalizations) had readmission rates of 26.2 and 16.6%, respectively. Factors independently associated with readmission included lower CD4 cell count [adjusted odds ratio 1.80 (1.53-2.11) for CD4 cell count <50 vs. ≥351 cells/μl], longer length of stay [1.77 (1.53-2.04) for ≥9 days vs. 1-3 days], and several diagnostic categories including ADI. Having an outpatient follow-up clinic visit was not associated with lower readmission risk [adjusted hazard ratio 0.98 (0.88-1.08)].
The 19.3% readmission rate exceeds the 13.3% rate reported for the general population of 18-64-year-olds. HIV providers may use the 19.3% rate as a basis of comparison. Policymakers may consider the impact of HIV when estimating expected readmissions for a hospital or region. Preventing or recovering from severe immune dysfunction may be the most important factor to reducing readmissions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>AIDS/HIV</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>United States</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Young Adult</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1LHEEQhhsxxHWTfyAyFyGXMf39cREWjbqwEAIm16amp9ttmZ1Zu2eV_fdpcbMmuXgqinrqrY8XoROCzwk26uuP2dU5bjBhnlHNJGWtCAdoQrhitRCKHKIJptLUhil8hI5zfsAYC6z1R3REmSQUYz1Bs7tlTOO2bmFbLYe8jiN0VfLQrmLOceirBKOvYDX09xW0m27MVRefYsme47isbue_PqEPAbrsP-_iFP28_nZ3eVsvvt_ML2eL2nFFxjKAqgbAOWW84iIIgCBCExrntCdaNFyZhgUKhjMmlSSBetloQ0B73RrKpujiVXe9aVa-db4fE3R2neIK0tYOEO2_lT4u7f3wZJkykkhRBL7sBNLwuPF5tOVG57sOej9ssiWKiTKHcvI-yg1W5X9aF5S_oi4NOScf9hsRbF-MssUo-79Rpe3072v2TX-cKcDZDoDsoAsJehfzG6ekUpJx9htbfZ3S</recordid><startdate>20130824</startdate><enddate>20130824</enddate><creator>BERRY, Stephen A</creator><creator>FLEISHMAN, John A</creator><creator>YEHIA, Baligh R</creator><creator>KORTHUIS, P. Todd</creator><creator>AGWU, Allison L</creator><creator>MOORE, Richard D</creator><creator>GEBO, Kelly A</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20130824</creationdate><title>Thirty-day hospital readmission rate among adults living with HIV</title><author>BERRY, Stephen A ; FLEISHMAN, John A ; YEHIA, Baligh R ; KORTHUIS, P. Todd ; AGWU, Allison L ; MOORE, Richard D ; GEBO, Kelly A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-da27baacc79e745f5aaf5fbfbcc8e185b479b3f2a94336761f2e6b891a8e8d923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>AIDS/HIV</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>United States</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BERRY, Stephen A</creatorcontrib><creatorcontrib>FLEISHMAN, John A</creatorcontrib><creatorcontrib>YEHIA, Baligh R</creatorcontrib><creatorcontrib>KORTHUIS, P. Todd</creatorcontrib><creatorcontrib>AGWU, Allison L</creatorcontrib><creatorcontrib>MOORE, Richard D</creatorcontrib><creatorcontrib>GEBO, Kelly A</creatorcontrib><creatorcontrib>HIV Research Network</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BERRY, Stephen A</au><au>FLEISHMAN, John A</au><au>YEHIA, Baligh R</au><au>KORTHUIS, P. Todd</au><au>AGWU, Allison L</au><au>MOORE, Richard D</au><au>GEBO, Kelly A</au><aucorp>HIV Research Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thirty-day hospital readmission rate among adults living with HIV</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2013-08-24</date><risdate>2013</risdate><volume>27</volume><issue>13</issue><spage>2059</spage><epage>2068</epage><pages>2059-2068</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>Thirty-day hospital readmission rate is receiving increasing attention as a quality-of-care indicator. The objective of this study was to determine readmission rates and to identify factors associated with readmission among persons living with HIV.
Prospective multicenter observational cohort.
Nine US HIV clinics affiliated through the HIV Research Network.
Patients engaged in HIV care during 2005-2010.
Readmission rate was defined as the proportion of hospitalizations followed by a readmission within 30 days. Factors in multivariate analyses included diagnostic categories, patient demographic and clinical characteristics, and having an outpatient follow-up visit.
Among 11,651 total index hospitalizations, the 30-day readmission rate was 19.3%. AIDS-defining illnesses (ADIs, 9.6% of index hospitalizations) and non-AIDS-defining infections (26.4% of index hospitalizations) had readmission rates of 26.2 and 16.6%, respectively. Factors independently associated with readmission included lower CD4 cell count [adjusted odds ratio 1.80 (1.53-2.11) for CD4 cell count <50 vs. ≥351 cells/μl], longer length of stay [1.77 (1.53-2.04) for ≥9 days vs. 1-3 days], and several diagnostic categories including ADI. Having an outpatient follow-up clinic visit was not associated with lower readmission risk [adjusted hazard ratio 0.98 (0.88-1.08)].
The 19.3% readmission rate exceeds the 13.3% rate reported for the general population of 18-64-year-olds. HIV providers may use the 19.3% rate as a basis of comparison. Policymakers may consider the impact of HIV when estimating expected readmissions for a hospital or region. Preventing or recovering from severe immune dysfunction may be the most important factor to reducing readmissions.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>23612008</pmid><doi>10.1097/QAD.0b013e3283623d5f</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0269-9370 |
| ispartof | AIDS (London), 2013-08, Vol.27 (13), p.2059-2068 |
| issn | 0269-9370 1473-5571 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adolescent Adult Aged Aged, 80 and over AIDS/HIV Biological and medical sciences Female HIV Infections - diagnosis HIV Infections - drug therapy Human immunodeficiency virus Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases Male Medical sciences Middle Aged Patient Readmission - statistics & numerical data Prospective Studies Risk Factors United States Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Young Adult |
| title | Thirty-day hospital readmission rate among adults living with HIV |
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