Analysis of healthcare outcomes and cost associated with cardiovascular conditions and stroke in human immunodeficiency virus (HIV) patients admitted in U.S. hospitals from 2012 to 2014
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Charles, Dréanne Laurent.
Analysis of healthcare outcomes and cost associated with cardiovascular conditions and stroke in human immunodeficiency virus (HIV) patients admitted in U.S. hospitals from 2012 to 2014. Retrieved from
https://doi.org/doi:10.7282/t3-rgax-yd55Export
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TitleAnalysis of healthcare outcomes and cost associated with cardiovascular conditions and stroke in human immunodeficiency virus (HIV) patients admitted in U.S. hospitals from 2012 to 2014
Date Created2019
Other Date2019-01 (degree)
Extent1 online resource (158 pages : illustrations)
DescriptionObjectives: To predict death, evaluate cost and hospital length of stay (LOS) associated with cardiovascular disease (CVD) and stroke in human immunodeficiency virus (HIV) patients during hospitalization.
Background: The risk for developing major CVDs and stroke in HIV individuals has been acknowledged. However, the healthcare outcomes, financial impact, and LOS linked to these diseases in hospitalized HIV individuals have not been concurrently and adequately evaluated.
Design: A retrospective observational study where hospital discharge data between 2012 and 2014 were obtained from the National Inpatient Sample (NIS). The Agency for Healthcare Research and Quality (AHRQ) comorbidity measure CM_AIDS was used to identify HIV patients with coexisting medical conditions. Furthermore, HIV patients with Acute Myocardial Infarction (AMI), Coronary Artery Disease (CAD), Congested Heart Failure (CHF), and Atrial Fibrillation (A Fib), and Stroke were selected using the appropriate International Classifications of Disease, Ninth Edition, Clinical Modification (ICD-9-CM) codes.
Method: Multivariate logistic regression and generalized linear (GLM) models were respectively used to predict death, evaluate cost and LOS.
Results: 39,540 de-identified HIV patients aged 18 to 79 years were selected for the study. From this cohort were AMI 573(1.45%), CAD 484(1.23%), CHF 1394(3.53%), and A Fib 440(1.11%), and stroke 725(1.84%). HIV patients with stroke were significantly more likely than HIV patients without stroke to die [OR = 4.721 95% CI (2.899-7.688)]. The likelihood of death for HIV patients with the remaining CVDs was observed as follows: CHF [OR = 2.610 95% CI (1.972-3.453)]; AMI [OR = 2.342 95% CI (1.576-3.480)]; A Fib [OR = 1.980 95% CI (0.783-5.002)]; and CAD [OR = 0.377 95% CI (0.140-1.014)]. HIV patients with AMI (P<.0001) incurred the highest average cost compared to HIV without AMI, followed by stroke (P<.0001), CHF (P<.0009), CAD (P<0.1456), and A Fib (P<0.3669). HIV patients with stroke (P<.0001) experienced a longer average LOS compared to HIV without stroke followed by CHF (P<.0059), CAD (P<.0328), A Fib (P<0.1032), and AMI (P<0.9401).
Conclusions: HIV patients with stroke were more likely to die and stay longer in hospital. CHF was more prevalent. AMI was costliest. Minimal disparity was observed in the analyses after adjusting for demographic and socio-economic factors. More studies are needed to confirm these results.
NotePh.D.
NoteIncludes bibliographical references
Noteby Dréanne Laurent Charles
Genretheses, ETD doctoral
Languageeng
CollectionSchool of Health Professions ETD Collection
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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