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Abstract
The role of Day-Hospital care of HIV disease, nine years after HAART introduction
Manfredi R.1, Calza L.1, Chiodo F.1
Introduction: Day-Hospital (DH) care still represents a key point of health care assistance of HIV-infected patients (p).
Methods: In order to assess the dynamics of admissions at a 4-bedded Infectious Disease (ID) DH, all hospitalizations were analyzed with respect to clinical-assistantial features.
Results: In the pre-HAART era (years 1994-1996), the low mean admission number (110/year), was linked to a prevalence of relapsing-prolonged HIV-related hospitalizations (~90% of admissions). After HAART introduction, DH admissions had a significant increase, from 171 in the year 1997, to 338 in 2003, and 183 in mid-2004 (p<.0001 versus the pre-HAART era), although this issue paralleled a concurrent drop of HIV-related ones (from 59.1% in 1997, to a minimum of 25.6% in 2001; p<.0001). While HIV-linked hospitalizations decreased, a huge increase of chronic liver disease occurred. The reduced duration of admission allowed an increase of overall number of hospitalizations, and the mean bed occupation rate varied from 8.2 in the year 2000, to 11.1 in 2003 (+284%; p<.0001). The evolution of ID DH assistance is therefore related to the broadening of disease spectrum, and the reduction of mean admission times. However, no significant changes occurred as to mean weight of diagnosis-related group (DRG) rates: from a mean 1.03 index of the year 2000, to a 1.02 rate of year 2003. This phenomenon depends on the maintenance of proportionally elevated DRG values of HIV disease complicated by opportunism or cancer (mean DRG 1.5±0.4), and the adjunctive impact of liver disorders (mean DRG 1.0±0.5).
Conclusions: Although DH resources did not vary, during the past decade an enlargement of disease spectrum, and an increase of absolute number of hospitalizations and occupancy and turnover rates, were found.A permanent monitoring of health care provisions at ID DH, may contribute to ensure adequate assistential planning, and resources allocation.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
WePe11.5C01
Suggested Citation
"ManfrediR., et al.
The role of Day-Hospital care of HIV disease, nine years after HAART introduction.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
WePe11.5C01"
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