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Fleishman John A.; Hellinger, Fred J.
JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1st, 2001
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Background and Objectives:Reports of declining HIV-related inpatient use have typically been based on limited or local data. Using comprehensive hospital discharge data from seven states, this study examines trends in HIV-related inpatient admission rates and lengths of stay from 1993 through 1997.

Methods:We identified HIV-related admissions by the International Classification of Diseases, ninth edition (ICD-9-CM) diagnosis codes in the range 042 to 044. Analyses assessed effects of state, gender, race/ethnicity, insurance, and time period; they also examined differential patterns of change.

Results:HIV-related inpatient admission rates rose between 1993 and 1995 but began declining steadily starting in late 1995. This general pattern occurred for all states, demographic groups, and insurers. The magnitude of the decline varied; admissions for white males and for patients with private insurance showed the greatest decreases. Admission rates were highest for African-American males and lowest for white females. Lengths of stay declined steadily; trends did not differ by demographic group or payer.

Conclusions:Results document the recent decline in HIV-related hospital admission rates. Relative declines in admissions parallel reported disparities in access to new antiretroviral therapies. Racial/ethnic disparities in inpatient use persist.

Address correspondence and reprint requests to John A. Fleishman, Agency for Healthcare Research and Quality, 2101 East Jefferson St., Rockville, MD 20852 U.S.A.; e-mail:

Manuscript received November 7, 2000; accepted May 29, 2001.

© 2001 Lippincott Williams & Wilkins, Inc.