Underdetection of pre-existing HIV/AIDS during psychiatric hospitalizations
| Autor: | Christina Mangurian, Priya Dahiya, Matthew L. Goldman, Tom Corbeil, Melanie M. Wall, Susan M. Essock, Lisa B. Dixon, Fei Tang, Eric Frimpong, Franco Mascayano, Marleen Radigan, Rui Wang, Mark Olfson, Thomas E. Smith |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Immunology
HIV Infections Medical and Health Sciences Article Clinical Research missed diagnosis Virology Immunology and Allergy Humans Aetiology Retrospective Studies Acquired Immunodeficiency Syndrome Inpatients Medicaid Mental Disorders severe Psychology and Cognitive Sciences Biological Sciences Brain Disorders HIV testing Hospitalization Infectious Diseases Mental Health Good Health and Well Being psychiatric HIV/AIDS Patient Safety Infection hospitals 2.4 Surveillance and distribution |
| Zdroj: | AIDS AIDS (London, England), vol 36, iss 7 |
| Popis: | OBJECTIVES: People with severe mental illness (SMI) are ten times more likely to have HIV/AIDS than the general population, yet little is known about the characteristics and frequency of recognition of pre-existing HIV/AIDS diagnoses among inpatients with SMI. This study examines documentation rates of pre-existing HIV/AIDS among inpatients within psychiatric hospitals in New York State. DESIGN: Retrospective cohort study to examine recognition of pre-existing HIV/AIDS among psychiatric inpatients. METHODS: Patient-level Medicaid claims records were linked with hospital and regional data for people admitted to psychiatric inpatient units in New York State. Presence of HIV/AIDS diagnoses prior to psychiatric hospitalization was coded for each inpatient (n=14,602). Adjusted odds ratios (aORs) of undocumented HIV/AIDS diagnoses at the time of discharge were calculated using logistic regression analyses. RESULTS: 5.1% (741/14,602) of unique psychiatric inpatients had pre-existing HIV/AIDS diagnoses. Of these inpatients, 58.3% (432/741) were not coded as having HIV/AIDS upon discharge. Higher rates of missed detection were associated with younger age, non-Hispanic white race/ethnicity, shorter length of stay, more distal coding of an HIV/AIDS diagnosis, and fewer HIV/AIDS-related Medicaid claims in the past year. Hospitals with higher re-admission rates also had higher rates of undetected HIV/AIDS diagnoses. CONCLUSION: Over half of inpatients previously diagnosed with HIV/AIDS did not have their HIV-positive status noted upon discharge from psychiatric hospitalization. This finding underscores how frequently clinically significant medical comorbidities fail to be incorporated into psychiatric treatment and treatment planning. Inpatient clinicians are missing important opportunities to optimize HIV/AIDS treatment and reduce morbidity and mortality. |
| Databáze: | OpenAIRE |
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