TY - JOUR
T1 - Relationship between ambulatory care accessibility and hospitalization for persons with advanced HIV disease
AU - Laine, Christine
AU - Markson, Leona E.
AU - Fanning, Thomas R.
AU - Turner, Barbara J.
PY - 1999/8
Y1 - 1999/8
N2 - Specific features of ambulatory care, such as accessibility, may influence hospital use for patients with HIV infection. To identify clinic features associated with a lower risk of hospitalization, 6,280 New York state Medicaid enrollees diagnosed with AIDS in 1987-1992 and managed by one of 157 surveyed clinics were studied. The odds of hospitalization in the year before AIDS diagnosis were associated with five clinic features that facilitate the accessibility of care: (1) evening/weekend hours, (2) case manager, (3) appointments within 48 hours, (4) telephone consultation, and (5) whether the clinic handled urgent care. Hospitalization in the year before AIDS diagnosis occurred for 49 percent of patients. Three of the five accessibility features had unadjusted associations with lower hospitalization rates. The adjusted odds of hospitalization were lower for patients in clinics with extended hours (OR = 0.77, 95% CI = 0.63,0.93) and for patients in clinics with four or more accessibility features compared with those in clinics with less than two features (OR = 0.67; 95% CI = 0.50, 0.89).
AB - Specific features of ambulatory care, such as accessibility, may influence hospital use for patients with HIV infection. To identify clinic features associated with a lower risk of hospitalization, 6,280 New York state Medicaid enrollees diagnosed with AIDS in 1987-1992 and managed by one of 157 surveyed clinics were studied. The odds of hospitalization in the year before AIDS diagnosis were associated with five clinic features that facilitate the accessibility of care: (1) evening/weekend hours, (2) case manager, (3) appointments within 48 hours, (4) telephone consultation, and (5) whether the clinic handled urgent care. Hospitalization in the year before AIDS diagnosis occurred for 49 percent of patients. Three of the five accessibility features had unadjusted associations with lower hospitalization rates. The adjusted odds of hospitalization were lower for patients in clinics with extended hours (OR = 0.77, 95% CI = 0.63,0.93) and for patients in clinics with four or more accessibility features compared with those in clinics with less than two features (OR = 0.67; 95% CI = 0.50, 0.89).
KW - Ambulatory care
KW - Health services research
KW - Hospitalization
KW - Human immunodeficiency virus
KW - Medicaid
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U2 - 10.1353/hpu.2010.0633
DO - 10.1353/hpu.2010.0633
M3 - Article
C2 - 10436730
AN - SCOPUS:0033174889
VL - 10
SP - 313
EP - 327
JO - Journal of Health Care for the Poor and Underserved
JF - Journal of Health Care for the Poor and Underserved
SN - 1049-2089
IS - 3
ER -