SOCIAL AND MEDICAL FACTORS AFFECTING HOSPITAL DISCHARGE OF PERSONS WITH HIV AIDS/

Although outpatient care and pharmaceuticals have rendered community-b ased care possible, hospitals remain the locus of the most costly and intensive HIV/AIDS care. Little is know however, about the impact of p atients' social circumstances upon hospital length of stay. This paper examines the impact of housing status, living arrangements, and a ran ge of barriers to discharge on hospital length of stay. Findings are b ased on retrospective medical chart reviews by nurses and social worke rs of 749 HIV/AIDS hospitalizations, occurring between June-August 199 1 in four New York City medical centers. One third of the sample exper ienced at least one barrier to discharge. Medical need barriers were t he most common (18%), and were associated with the longest length of s tay (35.3 days), followed by home care and housing barriers (32.7 and 30.2 days, respectively). Fourteen percent of the sample were either h omeless or in unstable housing situations (e.g., transient or ''double d up'') prior to admission. Homelessness and unstable housing were ass ociated with a 5 day increment in hospital length of stay, and remaine d a significant factor even controlling for morbidity. These results i ndicate that inadequate housing remains a significant barrier to disch arge among hospitalized persons with HIV/AIDS.