11
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Principal Components and Costs of HIV-Associated Hospitalizations in the United States: A National Study in the Current Era

      abstract
      , MD MPHS 1 , , MD 2
      Open Forum Infectious Diseases
      Oxford University Press

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          HIV-associated illness in the US has evolved with the advent of antiretroviral therapy and aging of the HIV-infected population. While changes in the causes of mortality in these patients are well documented, reasons for hospitalization and costs associated with hospital stays are not well studied at the national level.

          Methods

          We collected billing and demographic data of 84,666 HIV-associated hospitalizations across 3,564 hospitals nationwide using the 2012 and 2013 National Inpatient Sample, and used principal component analysis to arrive at predominant themes of HIV-associated hospitalization. Components with eigenvalues greater than one were retained, and orthogonal rotation was performed to identify variables that significantly loaded each component. Estimated hospital costs were determined by multiplying inflation-adjusted charges with hospital-specific cost-to-charge ratios and inverse wage indexes, and average costs associated with principal components were computed.

          Results

          Kidney disease predominated as a theme for HIV-associated hospitalization and accounted for 9% of the total variance. This was followed by liver disease, opportunistic infections with Pneumocystis and Candida, septicemia, and substance abuse, which accounted for 7%, 6%, 5% and 4% of the total variance respectively. Other significant contributors to hospitalization were heart disease, low socioeconomic status, complicated diabetes mellitus, and other opportunistic infections. The highest costs were associated with septicemia which averaged $25,557 per hospitalization, whereas the lowest costs were associated with substance abuse which averaged $7,534 per hospitalization.

          Conclusion

          Kidney and liver disease are important components of HIV-associated hospitalization in the current era reflecting an aging population overlain with complications from HIV and viral hepatitis. Opportunistic infections continue to be major contributors to hospitalization indicating ongoing challenges in access and adherence to antiretroviral therapy. Research efforts should focus on ameliorating HIV-related kidney and liver disease, as well as implementing strategies to promote early diagnosis and treatment of HIV.

          Disclosures

          All authors: No reported disclosures.

          Related collections

          Author and article information

          Journal
          Open Forum Infect Dis
          Open Forum Infect Dis
          ofid
          Open Forum Infectious Diseases
          Oxford University Press (US )
          2328-8957
          Fall 2017
          04 October 2017
          04 October 2017
          : 4
          : Suppl 1 , ID Week 2017 Abstracts
          : S434-S435
          Affiliations
          [1 ] Rush University Medical Center , Chicago, Illinois
          [2 ] ViiV Healthcare , Research Triangle Park, North Carolina
          Author notes

          Session: 157. HIV: Health Care Utilization and Costs

          Friday, October 6, 2017: 12:30 PM

          Article
          ofx163.1098
          10.1093/ofid/ofx163.1098
          5631205
          53c5f888-516d-4762-b909-bd6704e4550c
          © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

          History
          Page count
          Pages: 2
          Categories
          Abstracts
          Poster Abstract

          Comments

          Comment on this article