Emergency Department Utilization Among HIV-Infected Patients in a Multisite, Multistate Study

In the current study, the researchers set out to examine emergency department (ED) use among HIV-positive patients and the clinical and sociodemographic correlates of ED use by these patients.

In 2003 at 14 HIV clinics in the HIV Research Network, 951 patients took part in face-to-face interviews and were asked their number of ED visits in the previous six months. Logistic regression was employed to identify factors associated with visiting an ED in the past six months and admission to the hospital from the ED.

At least one ED visit in the previous six months was reported by 32 percent of respondents. Multivariate analysis showed any ED use was associated with Medicaid insurance, high levels of pain (third or fourth quartile), more than seven primary care visits in the preceding six months, current or former use of illicit drugs, social use of alcohol, and female gender. Thirty-nine percent of ED users had at least one hospital admission. Patients with pain in the highest quartile reported increased rates of admission from the ED, along with those who had six or seven primary care visits, or more than seven primary care visits vs. three or less.

"The likelihood of visiting the ED has not diminished since the advent of highly active antiretroviral therapy (HAART)," the authors concluded. "More ED visits are to treat illnesses not related to HIV or injuries than to treat direct sequelae of HIV infection. With the growing prevalence of people living with HIV infection, the numbers of HIV-infected patients visiting the ED may increase, and ED providers need to understand the potential complications produced by HIV disease."

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