Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil.

Cad Saude Publica. 1998 Oct-Dec;14(4):811-20. Unique Identifier : AIDSLINE MED/99147188
Acurcio F de A; Cesar CC; Guimaraes MD; Departamento de Farmacia Social e Curso de Doutorado em Ciencia; Animal, Universidade Federal de Minas Gerais, Av. Olegario; Maciel 2360, Belo Horizonte, MG 30180-112, Brasil.

Abstract: A historical cohort study was conducted in three public AIDS referral services in Belo Horizonte, Minas Gerais, to assess the relationship between health care utilization and patient survival following AIDS diagnosis. A review of medical and laboratory records was performed for HIV-infected patients seeking care for the first time in 1989-92. Among 291 patients initially categorized as 'A' [asymptomatic, acute HIV, or persistent generalized lymphadenopathy-PGL] or 'B' [symptomatic, non-'A', or AIDS-indicator conditions] (CDC, 1992) and who progressed to AIDS, 57.0% died. Mortality rate was 34.9 person-months. Overall median survival time following AIDS diagnosis was 14.3 months. Multivariate analysis showed that lack of AZT use (RR=1.87; 95% CI=1.34-2.61), advanced initial staging (RR=1.68; 95% CI=1.20-2.35), 9 or more inpatient days (RR=1.55; 95% CI=1.11-2.17), and intervals between outpatient visits longer than 6 months (RR=0.30; 95%CI= 0.16-0.56) were associated with death. The analysis suggests that: Patients who used health services more often had poorer prognosis; Patients who received AZT survived longer than those who did not; and variables used to assess health care utilization actually express the end of a process involving seeking and obtaining care.

Keywords: JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/MORTALITY/*THERAPY Adult Brazil/EPIDEMIOLOGY Cohort Studies Comparative Study Female Health Services/STATISTICS & NUMER DATA/*UTILIZATION Human HIV Seropositivity/MORTALITY/THERAPY *HIV-1/IMMUNOLOGY Male Multivariate Analysis Proportional Hazards Models Socioeconomic Factors Support, Non-U.S. Gov't Survival Analysis Time Factors
990630
A9960952

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