PATTERNS OF HOSPITAL USE BY PATIENTS WITH DIAGNOSIS RELATED TO HIV-INFECTION

The authors analyzed the use of hospitals by patients with a diagnosis of human immunodeficiency virus (HIV) infection, using data from the National Hospital Discharge Survey. In the period 1984-90, the rates o f both discharges and days of care for HIV-infected patients rose dram atically. For 1988-90, black males had the highest HIV-related dischar ge rate, followed by white males and black females, whose rates were s imilar. The discharge rate for patients with HIV-related diagnoses inc reased more in the Northeast than in the three other regions of the co untry. By 1990 the rate for the Northeast was nearly triple the rate f or other major regions. More than half of female and black patients wi th HIV-related diagnoses were hospitalized in the Northeast. Private i nsurance was the principal expected source of payment for the care of half of the HIV-infected patients discharged in 1985, but for only a t hird in 1990. Medicaid covered 40 percent of the patients with HIV-rel ated diagnoses discharged in 1990. Larger proportions of female than m ale patients and of black patients than white patients were covered by Medicaid. Acquired immunodeficiency syndrome was the diagnosis coded for most patients with an HIV-related diagnosis, but in larger proport ions for patients who were male or white patients. Nonspecific HIV dia gnoses were coded for larger proportions of female and black patients. HIV-infected patients had an average of 3.6 diagnoses in addition to their HIV diagnosis. Nearly a fourth of the additional diagnoses were for other infectious diseases, such as pneumocystosis or candidiasis. Anemia, pneumonia, and drug use and dependence also were frequent diag noses.