Relationship between ambulatory care accessibility and hospitalization for persons with advanced HIV disease.

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

Relationship between ambulatory care accessibility and hospitalization for persons with advanced HIV disease.

J Health Care Poor Underserved. 1999 Aug;10(3):313-27. Unique Identifier : AIDSLINE MED/99365783
Laine C; Markson LE; Fanning TR; Turner BJ; Thomas Jefferson University, USA.

Abstract: Specific features of ambulatory care, such as accessibility, may influence hospital use for patients with HIV infection. To identify clinic features associated with a lower risk of hospitalization, 6,280 New York state Medicaid enrollees diagnosed with AIDS in 1987-1992 and managed by one of 157 surveyed clinics were studied. The odds of hospitalization in the year before AIDS diagnosis were associated with five clinic features that facilitate the accessibility of care: (1) evening/weekend hours, (2) case manager, (3) appointments within 48 hours, (4) telephone consultation, and (5) whether the clinic handled urgent care. Hospitalization in the year before AIDS diagnosis occurred for 49 percent of patients. Three of the five accessibility features had unadjusted associations with lower hospitalization rates. The adjusted odds of hospitalization were lower for patients in clinics with extended hours (OR = 0.77, 95% CI = 0.63, 0.93) and for patients in clinics with four or more accessibility features compared with those in clinics with less than two features (OR = 0.67; 95% CI = 0.50, 0.89).

Keywords: JOURNAL ARTICLE Adolescence Adult Ambulatory Care Facilities/*ORGANIZATION & ADMIN Case Management Female Health Services Accessibility/*STANDARDS Health Services Research Hospitalization/*STATISTICS & NUMER DATA/TRENDS Hotlines Human HIV Infections/*ECONOMICS/*THERAPY Male Medicaid/TRENDS/UTILIZATION Middle Age New York Odds Ratio Retrospective Studies Support, U.S. Gov't, P.H.S. Time Factors United States
991130
A99B1070

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