Impact of Immunosuppression on Health Care Use by Men in the Multicenter AIDS Cohort Study (MACS)
作者:
Sharon Zucconi,
Lisa Jacobson,
Lewis Schrager,
Nancy Kass,
Judith Lave,
Catherine Carson,
Hal Morgenstern,
Peter Arno,
Neil Graham,
Multicenter Cohort Study,
期刊:
Journal of Acquired Immune Deficiency Syndromes
(OVID Available online 1994)
卷期:
Volume 7,
issue 6
页码: 607-616
ISSN:0894-9255
年代: 1994
出版商: OVID
关键词: Immunosuppression;HIV;Health care use;Cost
数据来源: OVID
摘要:
The effects of human immunodeficiency virus type 1 (HIV-1) serostatus, AIDS, and level of immunosuppression on health service use were examined in the Multicenter AIDS Cohort Study. Data on self-reported hospitalizations, outpatient medical services (non–emergency room) and emergency room care during the preceding 6 months were collected for 3,447 homosexual/bisexual men returning for their 14th and/or 15th semiannual visits in Chicago, Baltimore, Los Angeles, and Pittsburgh. AIDS-free seropositive men with CD4+cells+cells were >500/μl. Dramatic increases in outpatient care for each level of immunosuppression were observed. HIV-1-related symptoms were associated with increased hospitalizations (OR = 4.8, 95% CL = 3.2, 7.3), use of outpatient medical services (OR = 3.3, 95% CL = 1.9, 5.6), and emergency room care (OR = 3.1, 95% CL = 2.1, 4.6). Persons with AIDS and ±50 CD4+cells/μl were most likely to be hospitalized (OR = 8.1: 95% CL = 4.4, 14.9). No significant difference (p > 0.05) in emergency room use was observed according to HIV-1 serostatus, AIDS, or immunosuppression, after adjusting for insurance and clinical symptoms. To the extent that CD4+cell counts are used as one of the criteria for an AIDS diagnosis and such a diagnosis broadens available benefits to persons with HIV disease, the pattern of health care services described here will be important for health care providers and planners.
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