Abstract
BackgroundMajor depression disorder (MDD) is the most common psychiatric comorbidity in patients living with HIV (PLWHIV). The prevalence rate of MDD is higher in PLWHIV in comparison to the general population. In our study, we focus specifically on the 30-day readmission rate of PLWHIV and severe major depression.MethodsThe Health Care Agency (HCA) databank was used to conduct a retrospective study on PLWHIV and severe MDD. Keywords such as HIV, severe MDD, CD4, viral load were used to identify the data. 30-day readmission rate is studied in PLWHIV and severe MDD (N=143). Variables such as age, sex, gender, adherence to antiretroviral medications, cluster of differentiation 4 (CD4), and viral load were studied in this population. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria were used to diagnose severe MDD in PLWHIV. An antiretroviral therapy (ART) medication list was used to analyze adherence in this population group. Geographical locations were identified using urbanization codes.ResultsLogistic regression analysis for the 30-day readmission rate in PLWHIV was found to be higher in the older age group (p<0.01). Caucasian population (p<0.01) and rural areas (p<0.01), ART non-adherence (p<0.05), and severe major depression were also found to be significant in this population (p<0.01).ConclusionAs more patients live longer with HIV/AIDS, it gives rise to illnesses such as anxiety, depression, and cognitive impairment. Thus, it is important to identify severe depression in PLWHIV since it can have an impact on rates of hospitalization, morbidity/mortality, and the financial burden, specifically within 30-days of discharge.
Highlights
The 30-day readmission rates have become an integral quality care metric across healthcare since they may be associated with an increase in financial costs, psychosocial stressors, and mortality [1]
People living with HIV (PLWHIV) have been shown to have higher rates of readmission compared to the general population, despite the advances in HIV treatment in the form of highly active antiretroviral therapy (HAART) [2]
While the HAART era in the 1990s ushered in a period of steady decline associated with Acquired Immunodeficiency Syndrome (AIDS)-related complications, it resulted in an increase in the rates of hospitalizations and readmissions due to an increase in mental healthcare burden in this population group [3]
Summary
The 30-day readmission rates have become an integral quality care metric across healthcare since they may be associated with an increase in financial costs, psychosocial stressors, and mortality [1]. While the HAART era in the 1990s ushered in a period of steady decline associated with AIDS-related complications, it resulted in an increase in the rates of hospitalizations and readmissions due to an increase in mental healthcare burden in this population group [3]. While studies have been conducted on readmission rates in PLWHIV focusing on preventative measures and management techniques, they have been found too broad in their scope of review [3]. These studies are lacking in delineating which specific risk factors are associated with mental illnesses in HIV or 30-day readmission rates in this population group. We focus on the 30-day readmission rate of PLWHIV and severe major depression
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