Abstract
BackgroundThe 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.MethodsThe 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, 9th 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.ResultsA 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.ConclusionsDespite 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0801-8) contains supplementary material, which is available to authorized users.
Highlights
The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy
The incidence of advanced HIV infection is declining worldwide, the population of persons living with HIV (PLWHIV) continues to rise [2]
The Elixhauser Comorbidity Index (ECI) can adjust for confounding effects caused by the potential chronic disease burden when a condition is associated with a particular outcome [9]
Summary
The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy. The change in HIV-related hospitalizations in Portugal has not been studied. Since the HIV epidemic emerged in Portugal in 1983, 39,347 cases have been reported, and as of 2010, 16,370 patients have developed advanced HIV infection [1]. The incidence of advanced HIV infection is declining worldwide, the population of persons living with HIV (PLWHIV) continues to rise [2]. To determine the relationship between non-AIDS comorbidities and the progression of HIV disease, in the Catumbela et al BMC Health Services Research (2015) 15:144 present study we employed the Elixhauser Comorbidity Index (ECI), which is a comorbidity classification system used to describe and compare patient populations. We found that the ECI was associated with substantial increases in the frequency and duration of hospitalization, and mortality [10]. The ECI evaluates 30 comorbidities including HIV; we applied the ECI without including HIV as a comorbidity
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
