U.S. Hospitalization rates and reasons stratified by age among persons with HIV 2014–15

ABSTRACT

Persons with HIV (PWH) are aging. The impact of aging on healthcare utilization is unknown. The objective of this study was to evaluate hospitalization rates and reasons stratified by age among PWH in longitudinal HIV care. Hospitalization data from 2014–2015 was obtained on all adults receiving HIV care at 14 diverse sites within the HIV Research Network in the United States. Modified clinical classification software from the Agency for Healthcare Research and Quality assigned primary ICD-9 codes into diagnostic categories. Analysis performed with multivariate negative binomial regression. Among 20,608 subjects during 2014–2015, all cause hospitalization rate was 201/1000PY. Non-AIDS defining infection (non-ADI) was the leading cause for admission (44.2/1000PY), followed by cardiovascular disease (CVD) (21.2/1000PY). In multivariate analysis of all-cause admissions, the incidence rate ratio (aIRR) increased with older age (age 18–29 reference): age 30–39 aIRR 1.09 (0.90,1.32), age 40–49 1.38 (1.16,1.63), age 50–59 1.58 (1.33,1.87), and age ≥ 60 2.14 (1.77,2.59). Hospitalization rates increased significantly with age for CVD, endocrine, renal, pulmonary, and oncology. All cause hospitalization rates increased with older age, especially among non-communicable diseases (NCDs), while non-ADIs remained the leading cause for hospitalization. HIV providers should be comfortable screening for and treating NCDs.

KEYWORDS:

• Aging
• non-communicable disease
• hospitalization
• HIV

Acknowledgements

This research was supported by the Agency for Healthcare Research and Quality (HHSA290201100007C), and the Health Resources and Services Administration (HHSH250201600009C). Additionally, this work was supported by the National Institute of Health T32 AI007291-27 to Julia Fleming. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, AHRQ or HRSA.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by the Agency for Healthcare Research and Quality (HHSA290201100007C), and the Health Resources and Services Administration (HHSH250201600009C). Additionally, this work was supported by the National Institute of Health T32 AI007291-27 to Julia Fleming. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, AHRQ or HRSA.