IMPACT OF COMORBIDITIES ON THE RISK AND COST OF HOSPITALIZATION IN HIV-INFECTED PATIENTS- REAL WORLD DATA FROM THE ABRUZZO REGION
Author(s)
Cammarota S1, Citarella A1, Manzoli L2, Flacco ME3, Parruti G3
1LinhKealth Health Economics, Outcomes & Epidemiology s.r.l., Naples, Italy, 2University of Ferrara, Ferrara, Italy, 3Local Health Unit of Pescara, Pescara, Italy
OBJECTIVES: Due to the success of highly active antiretroviral therapy, HIV-infection has been transformed into a lifelong condition. Therefore, HIV-infected patients are more likely to experience age-associated comorbidities. Little is known about the impact of the comorbidities on the risk of hospitalization and related costs in HIV patients.Our aim was to quantify the risk of hospitalization and costs associated with comorbidities in HIV-infected patients. METHODS: The study population included subjects aged ≥with HIV infection, identified from the Abruzzo’s hospital discharge database during the years hospital discharge abstractseneralized linear model under gamma distribution was used to estimate adjusted mean hospital costsIRRs with 95% confidence interval (CI) were adjusted for age, gender and the other comorbidities. Costs were derived from official Italian DRG-based reimbursements. RESULTS: Among 1026 HIV patients identified (mean age 47 years), 30% experienced at least one comorbidity and 14.5% needed acute hospital admission during the follow-up period. The risk of acute hospitalization significantly increased among patients with renal (Adjusted IRR 2.27; 95%CI: 1.45-3.56), liver (IRR 2.21; 1.57-3.13), and chronic pulmonary comorbidities (IRR 2.31; 1.63-3.32). Adjusted mean hospital costs were €2,130 in patients without comorbidities, and €4,111 and €8,488 in those with CCI=1 or CCI≥2, respectively. CONCLUSIONS: The presence of renal, liver and chronic pulmonary comorbidities doubled the risk of hospitalization. A CCI≥2 was associated with a four-fold increase in hospitalization costs. Our experience underlines that antiretroviral treatment should be tailored in accordance with HIV-associated comorbidities, to minimize the risk of acute events during the chronic management of HIV-infection.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PIN7
Topic
Epidemiology & Public Health
Disease
Infectious Disease (non-vaccine)