OBJECTIVES

Literature shows that rates of hospital admission and readmissions increase as people living with HIV (PLWH) age. Few studies have investigated inpatient resource utilization for aging with HIV. We test the hypothesis that inpatient stays by older PLWH results in increased inpatient resource utilization.

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 <18 years. We have performed hierarchical linear modeling (HLM) to measure variations in procedure use and hospital length of stays (days) across different age groups and HIV status controlling for the different patient- and facility-level factors.

RESULTS

Among a weighted total of 19.6 million hospital stays (unweighted total of 3,920,328), 0.81% were made by PLWH. Mean number of procedure use was lower among hospital stays by PLWH (1.61 vs. 1.64 procedures), but the mean length of stays (LOS) was higher among PLWH (6.30 vs. 5.08 days). Controlling for between hospital variation and associated patient- and facility-level factors, mixed effects model showed that the number of procedure uses was lower among PLWH, but higher among older age groups. However, the number of procedure use was decreased among PLWH aged 36-49 years by 9.41% and 50-64 years by 8.43% than that of the younger PLWH aged 18-35 years. Moreover, LOS decreased with the increasing age of the patients, yet no significant variation of LOS exists across HIV status. No significant variations of LOS were observed in HIV and age group interaction.

CONCLUSIONS

Study findings challenge the literature from the perspective of U.S. inpatient stays, thus further investigation based on individual-level clinical records is needed to justify these findings. This holds implications for the health system, as proper planning is needed to meet increased medical demand as the PLWH population gets older.