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HIV disease burden, cost, and length of stay in Portuguese hospitals from 2000 to 2010: a cross-sectional study.

Catumbela E, Freitas A, Lopes F, Mendoza Mdel C, Costa C, Sarmento A, da Costa-Pereira A - BMC Health Serv Res (2015)

Bottom Line: The effect of Elixhauser comorbidity measures on extending the LOS was assessed by comparing admissions in HIV patients with and without comorbidities using the Mann-Whitney U test.During the period, inpatient HIV admissions decreased by 22%, LOS decreased by 9%, and in-hospital mortality dropped by 12%.Despite small regional variations, a strong, consistent decrease was observed in the hospital admission rate, mean cost, length of stay, and mortality rate for HIV-related admissions in Portugal during 2000-2010.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. ecassoco@gmail.com.

ABSTRACT

Background: The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy. However, the change in HIV-related hospitalizations in Portugal has not been studied. Using comprehensive hospital discharge data from mainland Portuguese hospitals, we examined trends in HIV-related inpatient admissions, length of stay (LOS), Elixhauser comorbidity measures, in-hospital mortality, and mean cost from 2000 to 2010.

Methods: The hospital administrative data from inpatient admissions and discharges at 75 public acute care hospitals in the Portuguese National Health Service from 2000 to 2010 were included. HIV-related admissions were identified using the International Classification of Diseases, 9(th) Revision, Clinical Modification diagnosis codes 042.x-044.x. The effect of Elixhauser comorbidity measures on extending the LOS was assessed by comparing admissions in HIV patients with and without comorbidities using the Mann-Whitney U test. Multivariate logistic regression was performed to estimate the odds of having a decreased discharge.

Results: A total of 57,027 hospital admissions were analyzed; 73% of patients were male, and the mean age was 39 years. The median LOS was 11 days, and the in-hospital mortality was 14%. The mean cost per hospitalization was 5,148.7€. A total of 83% of admissions were through the emergency room. During the period, inpatient HIV admissions decreased by 22%, LOS decreased by 9%, and in-hospital mortality dropped by 12%. Elixhauser comorbidities increased the median LOS in nearly all admissions.

Conclusions: Despite small regional variations, a strong, consistent decrease was observed in the hospital admission rate, mean cost, length of stay, and mortality rate for HIV-related admissions in Portugal during 2000-2010.

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Related in: MedlinePlus

PortugalNomenclature of Territorial Units for StatisticsII (NUTS II) regional map. The Norte, Centro, Lisbon, Alentejo, and Algarve regions were included in the present study.
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Fig1: PortugalNomenclature of Territorial Units for StatisticsII (NUTS II) regional map. The Norte, Centro, Lisbon, Alentejo, and Algarve regions were included in the present study.

Mentions: The country-wide distribution of hospitals was determined using the Nomenclature of Territorial Units for Statistics II (NUTS II), which is a geocode standard developed by the European Union for referencing the administrative divisions of countries for statistical purposes. The NUTS II level identifies the region by a two-digit or letter-digit code [17] and is only applied to the mainland regions of Portugal, namely Norte, Centro, Lisbon, Alentejo, and Algarve (Figure 1).Figure 1


HIV disease burden, cost, and length of stay in Portuguese hospitals from 2000 to 2010: a cross-sectional study.

Catumbela E, Freitas A, Lopes F, Mendoza Mdel C, Costa C, Sarmento A, da Costa-Pereira A - BMC Health Serv Res (2015)

PortugalNomenclature of Territorial Units for StatisticsII (NUTS II) regional map. The Norte, Centro, Lisbon, Alentejo, and Algarve regions were included in the present study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403787&req=5

Fig1: PortugalNomenclature of Territorial Units for StatisticsII (NUTS II) regional map. The Norte, Centro, Lisbon, Alentejo, and Algarve regions were included in the present study.
Mentions: The country-wide distribution of hospitals was determined using the Nomenclature of Territorial Units for Statistics II (NUTS II), which is a geocode standard developed by the European Union for referencing the administrative divisions of countries for statistical purposes. The NUTS II level identifies the region by a two-digit or letter-digit code [17] and is only applied to the mainland regions of Portugal, namely Norte, Centro, Lisbon, Alentejo, and Algarve (Figure 1).Figure 1

Bottom Line: The effect of Elixhauser comorbidity measures on extending the LOS was assessed by comparing admissions in HIV patients with and without comorbidities using the Mann-Whitney U test.During the period, inpatient HIV admissions decreased by 22%, LOS decreased by 9%, and in-hospital mortality dropped by 12%.Despite small regional variations, a strong, consistent decrease was observed in the hospital admission rate, mean cost, length of stay, and mortality rate for HIV-related admissions in Portugal during 2000-2010.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. ecassoco@gmail.com.

ABSTRACT

Background: The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy. However, the change in HIV-related hospitalizations in Portugal has not been studied. Using comprehensive hospital discharge data from mainland Portuguese hospitals, we examined trends in HIV-related inpatient admissions, length of stay (LOS), Elixhauser comorbidity measures, in-hospital mortality, and mean cost from 2000 to 2010.

Methods: The hospital administrative data from inpatient admissions and discharges at 75 public acute care hospitals in the Portuguese National Health Service from 2000 to 2010 were included. HIV-related admissions were identified using the International Classification of Diseases, 9(th) Revision, Clinical Modification diagnosis codes 042.x-044.x. The effect of Elixhauser comorbidity measures on extending the LOS was assessed by comparing admissions in HIV patients with and without comorbidities using the Mann-Whitney U test. Multivariate logistic regression was performed to estimate the odds of having a decreased discharge.

Results: A total of 57,027 hospital admissions were analyzed; 73% of patients were male, and the mean age was 39 years. The median LOS was 11 days, and the in-hospital mortality was 14%. The mean cost per hospitalization was 5,148.7€. A total of 83% of admissions were through the emergency room. During the period, inpatient HIV admissions decreased by 22%, LOS decreased by 9%, and in-hospital mortality dropped by 12%. Elixhauser comorbidities increased the median LOS in nearly all admissions.

Conclusions: Despite small regional variations, a strong, consistent decrease was observed in the hospital admission rate, mean cost, length of stay, and mortality rate for HIV-related admissions in Portugal during 2000-2010.

Show MeSH
Related in: MedlinePlus