6 Facts To Know About HIV Readmissions
1 in 4 return to the hospital in 30 days
A new report unveiled by the Pittsburgh Regional Health Initiative provides a comprehensive picture of hospital readmissions for People Living with HIV and AIDS (PLWHA).
Drawing on de-identified data regarding hospital admissions of nearly 10,000 PLWHA in Pennsylvania, the report looks at trends, demographics, and disparities in hospital readmissions. The six most important findings are highlighted below:
1. HIV has one of the highest 30-day hospital readmission rate of all conditions.
In a two year span, one-third of the state’s population of PLWHA were hospitalized at least once. The readmission rate for HIV/AIDS is a staggering 28%, meaning 1 in 4 hospitalized PLWHA will return within 30 days. Overall, the readmission rate for HIV/AIDS is nearly double the rate for all conditions (15%).
2. PLWHA are admitted for a number of reasons.
10 diagnoses were present on 87% of admissions of PLWHA. These consist of behavioral health comorbidities, which were present on 35% of all admissions, and co-occurring chronic conditions like hypertension. We know from our statewide initiative linking PLWHA to medical care that sometimes managing these other conditions first is the key to achieving and maintaining suppressed HIV viral loads.
3. Admission and readmission disparities between African American and white PLWHA appear minimal.
The 30-day HIV hospital readmissions rates for African American PLWHA (29%) and white PLWHA (27%) both closely relate to the overall HIV/AIDS rate of 28%. Of course, these are all too high. But the disparity seen in diagnosis rates between the groups doesn’t hold in terms of being readmitted to the hospital. Similarly, rates of hospital admission appear to generally reflect the HIV prevalence rates among the two groups as well.
4. More than half of all hospitalized PLWHA were readmitted within 12 months.
30-day readmission rates are an important enough indicator of care quality that they are now being tied to Medicaid reimbursement. However, 12-month rates give a better indicator about long term health for PLWHA. This poses a new challenge and urgency for closely linking HIV medical and social services. If we can improve retention in care programs, it’s likely we can decrease the number of people who need to visit the hospital multiple times per year.
5. The older population of PLWHA accounts for a disproportionate amount of admissions.
PLWHA who are more than 49 years old account for only about 10% of PLWHA (in this data), yet represent 41% of hospital admissions. As PLWHA live longer and face complications associated with aging, the likelihood they’ll be admitted to the hospital increases. This mirrors hospital utilization in the general aging population as well.
6. 30-day readmission rates vary between hospitals
There are important differences in readmission rates between different hospitals, indicating the possibility that public reporting would help PLWHA choose care at facilities with lower readmission rates for those with HIV. Thankfully, we know that readmission rates can be considerably reduced even at hospitals with better-than-average rates.
To take a look at more findings in the full report, click here.
To chat about the article, email Kyle Crawford at crawford@jhf.org
