OBJECTIVES

This study hypothesizes that hospital stays by the people living with HIV (PLWH) at their older age is associated with more comorbidities and a higher severity of illness than that of the general population, which eventually increase inpatient resource utilization and costs of inpatient care. The purpose of this study was to examine costs variations across different age groups of PLWH during U.S. inpatient hospital stays.

METHODS

National Inpatient Sample (NIS) 2015 data were analyzed in SAS version 9.4, after excluding hospital stays for maternal or neonatal diagnoses and by the patients less than 18 years. We have performed hierarchical linear modeling (HLM) to measure variations in inpatient costs across different age groups and HIV status controlling for various patient- and facility-level factors.

RESULTS

Among a total of 3,920,328 inpatient discharge records (weighted total of 19,601,638), the mean costs of the hospital stays was $13,044, when median costs was $8,316. Multivariable mixed effects model demonstrates that hospital stays by the PLWH were 7.18% higher costly than that for other hospital stays. Costs were increased with the increasing age of the patients; patients aged 36-49 years spent 7.18%, 50-64 years spent 14.82%, and 65+ years spent 14.49% higher than that of the younger age group (18-35 years). Interestingly, inpatient costs decreased with the increasing age of the PLWH; average costs were decreased by around 6.47% for 50-64 years and by 6.34% for 65+ years, and by 3% for aged 36-49 years than that of younger (18-35 years) PLWH.

CONCLUSIONS

Study findings indicate that when it was expected there is higher demand for inpatient care with aging of PLWH, lower costs for hospital stays may refer stability of viral loads and good coverage of insurance plans as PLWH age.