PREVIOUSLY UNRECOGNIZED HIV-INFECTION AMONG HOSPITALIZED-PATIENTS

We reviewed records of 150 patients found to be HIV-infected while hos pitalized between November 1991 and February 1993. One hundred (67%) w ere uninsured, and 33 (22%) were insured by Medicaid. There were 1606 hospital days, and 24 (16%) were admitted to an intensive care unit (t otal 153 days). Hospital charges totaled $1.6 million, 69% to uninsure d patients. CD4 lymphocyte counts were <200/mm(3) in 50 (57%) and <500 /mm(3) in 75 (86%) of the 87 patients in whom they were measured. Diag noses included AIDS indicator conditions in 21 (14%) and pyogenic bact erial infections in 59 (39%). Since 1988, 141 (94%) had prior hospital izations (total 103), emergency department visits (543), or clinic vis its (160) at this hospital. Despite multiple encounters with the healt h care system, many patients with advanced HIV infection were only ide ntified during hospitalization. In hospitals with high prevalences of HIV infection, voluntary testing and enrollment in medical care may re duce costs and decrease morbidity from preventable illness.