Hospital Readmissions Among Persons With Human Immunodeficiency Virus in the United States and Canada, 2005-2018 : A Collaboration of Cohort Studies
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: Hospital readmission trends for persons with human immunodeficiency virus (PWH) in North America in the context of policy changes, improved antiretroviral therapy (ART), and aging are not well-known. We examined readmissions during 2005-2018 among adult PWH in NA-ACCORD.
METHODS: Linear risk regression estimated calendar trends in 30-day readmissions, adjusted for demographics, CD4 count, AIDS history, virologic suppression (<400 copies/mL), and cohort.
RESULTS: We examined 20 189 hospitalizations among 8823 PWH (73% cisgender men, 38% White, 38% Black). PWH hospitalized in 2018 versus 2005 had higher median age (54 vs 44 years), CD4 count (469 vs 274 cells/μL), and virologic suppression (83% vs 49%). Unadjusted 30-day readmissions decreased from 20.1% (95% confidence interval [CI], 17.9%-22.3%) in 2005 to 16.3% (95% CI, 14.1%-18.5%) in 2018. Absolute annual trends were -0.34% (95% CI, -.48% to -.19%) in unadjusted and -0.19% (95% CI, -.35% to -.02%) in adjusted analyses. By index hospitalization reason, there were significant adjusted decreases only for cardiovascular and psychiatric hospitalizations. Readmission reason was most frequently in the same diagnostic category as the index hospitalization.
CONCLUSIONS: Readmissions decreased over 2005-2018 but remained higher than the general population's. Significant decreases after adjusting for CD4 count and virologic suppression suggest that factors alongside improved ART contributed to lower readmissions. Efforts are needed to further prevent readmissions in PWH.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:228 |
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| Enthalten in: |
The Journal of infectious diseases - 228(2023), 12 vom: 20. Dez., Seite 1699-1708 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Davy-Mendez, Thibaut [VerfasserIn] |
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| Links: |
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| Themen: |
Aging |
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| Anmerkungen: |
Date Completed 22.12.2023 Date Revised 20.04.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/infdis/jiad396 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM361953364 |
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| 245 | 1 | 0 | |a Hospital Readmissions Among Persons With Human Immunodeficiency Virus in the United States and Canada, 2005-2018 |b A Collaboration of Cohort Studies |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 20.04.2024 | ||
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Hospital readmission trends for persons with human immunodeficiency virus (PWH) in North America in the context of policy changes, improved antiretroviral therapy (ART), and aging are not well-known. We examined readmissions during 2005-2018 among adult PWH in NA-ACCORD | ||
| 520 | |a METHODS: Linear risk regression estimated calendar trends in 30-day readmissions, adjusted for demographics, CD4 count, AIDS history, virologic suppression (<400 copies/mL), and cohort | ||
| 520 | |a RESULTS: We examined 20 189 hospitalizations among 8823 PWH (73% cisgender men, 38% White, 38% Black). PWH hospitalized in 2018 versus 2005 had higher median age (54 vs 44 years), CD4 count (469 vs 274 cells/μL), and virologic suppression (83% vs 49%). Unadjusted 30-day readmissions decreased from 20.1% (95% confidence interval [CI], 17.9%-22.3%) in 2005 to 16.3% (95% CI, 14.1%-18.5%) in 2018. Absolute annual trends were -0.34% (95% CI, -.48% to -.19%) in unadjusted and -0.19% (95% CI, -.35% to -.02%) in adjusted analyses. By index hospitalization reason, there were significant adjusted decreases only for cardiovascular and psychiatric hospitalizations. Readmission reason was most frequently in the same diagnostic category as the index hospitalization | ||
| 520 | |a CONCLUSIONS: Readmissions decreased over 2005-2018 but remained higher than the general population's. Significant decreases after adjusting for CD4 count and virologic suppression suggest that factors alongside improved ART contributed to lower readmissions. Efforts are needed to further prevent readmissions in PWH | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a aging | |
| 650 | 4 | |a healthcare utilization | |
| 650 | 4 | |a hospitalization | |
| 650 | 4 | |a readmission | |
| 700 | 1 | |a Napravnik, Sonia |e verfasserin |4 aut | |
| 700 | 1 | |a Hogan, Brenna C |e verfasserin |4 aut | |
| 700 | 1 | |a Eron, Joseph J |e verfasserin |4 aut | |
| 700 | 1 | |a Gebo, Kelly A |e verfasserin |4 aut | |
| 700 | 1 | |a Althoff, Keri N |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Richard D |e verfasserin |4 aut | |
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| 700 | 1 | |a Rebeiro, Peter F |e verfasserin |4 aut | |
| 700 | 1 | |a Karris, Maile Y |e verfasserin |4 aut | |
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| 700 | 1 | |a Kitahata, Mari M |e verfasserin |4 aut | |
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| 700 | 1 | |a Berry, Stephen A |e verfasserin |4 aut | |
| 700 | 0 | |a North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International epidemiology Databases to Evaluate AIDS (IeDEA) |e verfasserin |4 aut | |
| 700 | 1 | |a Benson, Constance A |e investigator |4 oth | |
| 700 | 1 | |a Bosch, Ronald J |e investigator |4 oth | |
| 700 | 1 | |a Kirk, Gregory D |e investigator |4 oth | |
| 700 | 1 | |a Greenberg, Alan E |e investigator |4 oth | |
| 700 | 1 | |a Castel, Amanda D |e investigator |4 oth | |
| 700 | 1 | |a Monroe, Anne K |e investigator |4 oth | |
| 700 | 1 | |a Marconi, Vincent |e investigator |4 oth | |
| 700 | 1 | |a Colasanti, Jonathan |e investigator |4 oth | |
| 700 | 1 | |a Mayer, Kenneth H |e investigator |4 oth | |
| 700 | 1 | |a Grasso, Chris |e investigator |4 oth | |
| 700 | 1 | |a Hogg, Robert S |e investigator |4 oth | |
| 700 | 1 | |a Lima, Viviane D |e investigator |4 oth | |
| 700 | 1 | |a Montaner, Julio S G |e investigator |4 oth | |
| 700 | 1 | |a Salters, Kate |e investigator |4 oth | |
| 700 | 1 | |a Buchacz, Kate |e investigator |4 oth | |
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| 700 | 1 | |a Betts, Adrian |e investigator |4 oth | |
| 700 | 1 | |a Lindsay, Joanne |e investigator |4 oth | |
| 700 | 1 | |a Nijhawan, Ank |e investigator |4 oth | |
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| 700 | 1 | |a Gill, M John |e investigator |4 oth | |
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| 700 | 1 | |a Li, Jun |e investigator |4 oth | |
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| 700 | 1 | |a Mugavero, Michael J |e investigator |4 oth | |
| 700 | 1 | |a Burkholder, Greer |e investigator |4 oth | |
| 700 | 1 | |a Bamford, Laura |e investigator |4 oth | |
| 700 | 1 | |a Karris, Maile |e investigator |4 oth | |
| 700 | 1 | |a Eron, Joseph J |e investigator |4 oth | |
| 700 | 1 | |a Napravnik, Sonia |e investigator |4 oth | |
| 700 | 1 | |a Kitahata, Mari M |e investigator |4 oth | |
| 700 | 1 | |a Crane, Heidi M |e investigator |4 oth | |
| 700 | 1 | |a Sterling, Timothy R |e investigator |4 oth | |
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| 700 | 1 | |a Lee, Jennifer S |e investigator |4 oth | |
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| 700 | 1 | |a Humes, Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Lang, Raynell |e investigator |4 oth | |
| 700 | 1 | |a Coburn, Sally |e investigator |4 oth | |
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