Sex-Ethnic Disparities in HIV-Related Hospitalization and Mortality in Florida

Abstract

Purpose To determine the racial/ethnic-differences in characteristics of inpatients hospitalized for Human immunodeficiency virus (HIV) disease/illness by gender and the correlates of HIV-related mortality in Florida. Methods A retrospective analyses of public use data from the Florida Agency for Health Care Administration (AHCA), 2001 was utilized. From the de-identified hospital discharge file, discharge records with primary diagnosis of HIV disease/illness using the International Classification of Diseases, Ninth Edition (ICD 9) code were included. There were 9,279 inpatient records with diagnoses of HIV disease or illness. However, 9,113 records that belonged to black, white, and Hispanic patients were included in the analyses. The differences between sex-race/ethnic groups were tested using the chi-square tests and general linear models. In addition, multivariable logistic regression models were fitted to evaluate the correlates of HIV-related mortality in Florida Hospitals. Results Of 9,113 records, 64%, 23%, and 13% of records belonged to blacks, whites, and Hispanics, respectively. The type of admission, discharge status, length of hospital stay, health insurance status and age differed in six sex-, race/ethnic-specific groups. HIV-related mortality was significantly correlated with insurance status, age, and length of hospital stay. Under- or uninsured patients were about 27% more likely to die than those patients who had commercial health insurance. Older individuals (> 40 years) and those who stayed in hospitals more than 6 days were at higher risks of death compared with their reference groups (≤ 40 years old and ≤ 6 days of hospital stay). Conclusion The potential causes (severity of disease, co-infections, preventive care, socio-economic status, cultural norms and beliefs about HIV) of disparities between sex-, race/ethnic-groups of Florida should be further explored.