Organization and outcomes of inpatient AIDS care

OBJECTIVE. TO compare differences in AIDS patients' 30-day mortality and sa tisfaction with care in dedicated AIDS units, scattered-bed units in hospit als with and without dedicated AIDS units, and in magnet hospitals known to provide good nursing care. METHODS. Data were obtained on 1,205 consecutively admitted patients in 40 units in 20 hospitals and on 820 of their nurses. RESULTS. Mortality was lower and satisfaction was higher for AIDS patients in dedicated AIDS units and in nursing magnet hospitals. Primary nursing en d-of-life care counseling and discharge planning were also more common. Hig her nurse to patient ratios and AIDS physician specialty services were stro ngly associated with lower mortality. Patient satisfaction was strongly ass ociated with organizational control of care by bedside nurses. Homosexuals were more likely to be admitted to dedicated AIDS units,which largely expla ins the under-representation of minorities and women CONCLUSIONS. Dedicated AIDS units and magnet hospitals offer important bene fits to AIDS patients, including lower odds on dying within 30 days of admi ssion, higher patient satisfaction, and care meeting professional standards . Better nurse staffing, AIDS physician specialty services, and more organi zational control by bedside nurses improve patient outcomes.