Jia H (Rehabilitation Outcomes Research Center)
Uphold CR (Rehabilitation Outcomes Research Center)
Zheng Y (Rehabilitation Outcomes Research Center)
Wu SS (Rehabilitation Outcomes Research Center)
Chen GJ (Wake Forest University School of Medicine)
Duncan PW (Rehabilitation Outcomes Research Center)
The objective of this study was to compare inpatient and outpatient healthcare utilization between veteran and non-veteran men with HIV infection.
In a prospective cohort study on health outcomes in HIV-infected men, baseline and 12-month followup data were collected on 197 men with HIV infection. Data included in this study were the number of inpatient stays and outpatient visits during the last 12 months, demographic characteristics, clinical factors, and depressive symptoms (CES-D). Collinearity diagnostics were calculated to measure the degrading or harmful multicollinearity among the independent (veterans vs. non-veterans) and controlling variables (age, race, education, CD4 count, Charlson’s comorbidity, duration since HIV diagnosis, depressive symptoms, and study time point). Poisson regression with repeated measures was performed.
The sample consisted of 61% veterans and 44% non-whites with a mean age of 46 years. The means at baseline for the sample were 13 years for schooling, 426 for CD4 count, 1 for Charlson’s comorbidity after excluding AIDS diagnosis, 8 years for HIV infection duration, and 15 for CES-D. Bivariate analyses of these factors showed no significant difference between the two groups of patients (veterans vs. non-veterans) except that the veteran patients were significantly lower in CD4 count (474 vs. 350, p=0.03) than the non-veterans. Our Poisson regression showed that the veteran patients had significantly fewer inpatient stays than the non-veteran patients (-0.5737, p=0.03), and that their number of physician visits was not different from that of the non-veterans, after adjusting for the demographic, clinical, depressive, and time factors.
Our findings suggest that while there was no significant difference in outpatient care utilization between the veteran and non-veteran men with HIV infection, the HIV-infected veterans used less inpatient services than the non-veteran men.
Our findings on the inpatient and outpatient healthcare utilization by veteran and non-veteran men with HIV infection can assist our program planners in developing medical service delivery for HIV-infected male veterans.