Abstract
It is important that the utilization of emergency departments (EDs) among people living with the human immunodeficiency virus (HIV) be epidemiologically evaluated in order to assess and improve the HIV care continuum. All participants newly-diagnosed with HIV in Taiwan registered in the National Health Insurance Database from 2000 to 2005 were enrolled in this study and followed-up from 2006 to 2011. In total, 3500 participants newly-diagnosed with HIV in 2000–2005 were selected as a fixed-cohort population and followed-up from 2006 to 2011. Overall, 704, 645, 591, 573, 578, and 568 cases made 1322, 1275, 1050, 1061, 1136, and 992 ED visits in 2006, 2007, 2008, 2009, 2010 and 2011, respectively, with an average number of ED visits ranging from 1.75 to 1.98 per person, accounting for 20.1–22.6% of the whole HIV-positive population. Fewer ED visits were due to traumatic reasons, accounting for 19.6–24.4% of all cases. The incidence of traumatic and non-traumatic ED visits among the HIV-positive participants ranged from 7.2–9.3 and 27.0–33.9 per 100 people, respectively. The average direct medical cost of traumatic and non-traumatic ED visits ranged from $89.3–112.0 and $96.6–120.0, respectively. In conclusion, a lower incidence of ED visits for all reasons and fewer ED visits owing to traumatic causes were observed in the population living with HIV in comparison with the general population; however, the direct medical cost of each ED visit owing to both traumatic and non-traumatic causes was greater among those living with HIV than in the general population.
Highlights
The human immunodeficiency virus (HIV) care continuum was established to improve the population’s understanding of the HIV epidemic as a whole
Definition of the Enrolled Study Population. In this retrospective fixed-cohort study, we examined the health insurance records of 23 million beneficiaries registered in the NHI Research Database (NHIRD) from 2000 to 2005, and enrolled all participants newly-diagnosed with HIV based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes 042.X (HIV infection) and V08.X
Of 107 HIV-positive cases enrolled in a prospective study in the USA, 36% were noted to have received inadequate HIV care (IHC); IHC did not predict a greater frequency of emergency departments (EDs) visits [13]
Summary
The human immunodeficiency virus (HIV) care continuum was established to improve the population’s understanding of the HIV epidemic as a whole. The spectrum of commitment to the care of persons living with HIV focuses on test-and-treat strategies in particular [1]. HIV epidemic study including 18,144 adults was performed between 1987 and 2013; the HIV-positive sero-prevalence was 5.2% in 1987; this increased to more than 11% from 1992 to 2003, diminished to 5.6% in 2013. Among the HIV-positive subjects, the proportion of those with an undiagnosed. Res. Public Health 2017, 14, 1214; doi:10.3390/ijerph14101214 www.mdpi.com/journal/ijerph
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