HIV disease burden, cost, and length of stay in Portuguese hospitals from 2000 to 2010: A cross-sectional study

Abstract

Background: The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy. However, the change in HIV-related hospitalizations in Portugal has not been studied. Using comprehensive hospital discharge data from mainland Portuguese hospitals, we examined trends in HIV-related inpatient admissions, length of stay (LOS), Elixhauser comorbidity measures, in-hospital mortality, and mean cost from 2000 to 2010. Methods: The hospital administrative data from inpatient admissions and discharges at 75 public acute care hospitals in the Portuguese National Health Service from 2000 to 2010 were included. HIV-related admissions were identified using the International Classification of Diseases, 9 th Revision, Clinical Modification diagnosis codes 042.x-044.x. The effect of Elixhauser comorbidity measures on extending the LOS was assessed by comparing admissions in HIV patients with and without comorbidities using the Mann-Whitney U test. Multivariate logistic regression was performed to estimate the odds of having a decreased discharge. Results: A total of 57,027 hospital admissions were analyzed; 73% of patients were male, and the mean age was 39 years. The median LOS was 11 days, and the in-hospital mortality was 14%. The mean cost per hospitalization was 5,148.7€. A total of 83% of admissions were through the emergency room. During the period, inpatient HIV admissions decreased by 22%, LOS decreased by 9%, and in-hospital mortality dropped by 12%. Elixhauser comorbidities increased the median LOS in nearly all admissions. Conclusions: Despite small regional variations, a strong, consistent decrease was observed in the hospital admission rate, mean cost, length of stay, and mortality rate for HIV-related admissions in Portugal during 2000-2010.