PREDICTORS OF RESOURCE UTILIZATION FOR HOSPITALIZED-PATIENTS WITH PNEUMOCYSTIS-CARINII PNEUMONIA (PCP) - A SUMMARY OF EFFECTS FROM THE MULTI-CITY STUDY OF QUALITY OF PCP CARE

To determine whether patient and hospital characteristics were signifi cantly associated with variations in Pneumocystis carinii (PCP) care a nd outcomes, we analyzed the use of diagnostic tests, intensive care u nits (ICUs), anti-PCP medications for persons hospitalized with human immunodeficiency virus (HIV)-related PCP, and hospital discharge statu s. We conducted retrospective chart reviews of a cohort of 2,174 patie nts with PCP hospitalized in 1987-1990. Outcomes included process of c are for PCP and in-hospital mortality rates. Persons with PCP who were more severely ill at admission were more likely to have early medical care, to receive care in an intensive care unit, and to die in hospit al. After we adjusted for differences in this severity of illness, we noted that Medicaid patients, injection drug users (IDUs), and patient s treated at VA or county hospitals were significantly less likely tha n others to have diagnostic bronchoscopies and that persons covered by Medicaid, with a previous diagnosis of acquired immunodeficiency synd rome (AIDS), who did not receive prior zidovudine (AZT) or who receive d care in a VA hospital had the highest chances of in-hospital death. Insurance and risk group characteristics, severity of illness, and hos pital characteristics appear to be the most important determinants of the intensity and timing of medical care and outcomes among patients h ospitalized with PCP.