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Sunday, 17 October 2004

This presentation is part of: Poster Session - Public Health; Methodological Advances

HEALTH CARE UTILIZATION IN PERINATALLY HIV-INFECTED U.S. CHILDREN: 2001 V. 1995

Stephanie Sansom, PhD1, John Anderson, PhD1, Thom Sukalac, BA1, Sada Soorapanth, PhD1, Jill Clark, MPH1, Jeanne Bertolli, PhD2, and Ken Dominguez, MD1. (1) Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, (2) Centers for Disease Control and Prevention, Office of Health Disparities, National Center for HIV, STD, and TB Prevention, Atlanta, GA

Purpose: Current measures of health care demanded by children perinatally infected with HIV are useful to assess the cost-effectiveness of prevention programs. Assessing health care utilization over time demonstrates the impact of new therapies.

Methods: The Pediatric Spectrum of Disease (PSD) study collects longitudinal data on HIV-infected children in six sites in the U.S. from the time of HIV diagnosis or exposure through death. We assessed health care utilization including hospitalizations, and HIV-related prescription drugs and laboratory tests, during the years 1995 and 2001 for all perinatally HIV infected children PSD. We assessed statistical significance between the two years using t-tests of difference in proportions and means.

Results: In 2001, 1,903 perinatally infected children were enrolled in PSD, with a median age of 9.0 years, compared with 2,246 children enrolled in 1995 with a median age of 4.9 years. During 2001, 13.9% of enrollees were hospitalized at least once (854 total hospitalizations) compared with 31.3% hospitalized at least once (2,796 total hospitalizations) in 1995 (p<.05). The rate of hospitalization was .2 per child-year in 2001 compared with .7 per child-year in 1995 (p<.05). Average length of hospital stay was 9.5 days in 2001, compared with 8.5 days in 1995 for an average 2.0 hospital days/child-year in 2001 and 5.1 hospital days/child-year in 1995 (p<.05). On average, children were prescribed 3.5 antiretroviral drugs in 2001 compared with 2.1 in 1995 (p<.05), and an average of 17.5 HIV-related lab tests were ordered for each child during 2001 compared with 12.8 during 1995 (p<.05).

Conclusions: Hospitalization among perinatally infected children in the United States decreased significantly from 1995 to 2001. The number of prescribed antiretroviral drugs and ordered laboratory tests increased. Future analysis should include the costs associated with health care utilization to determine if resource use overall has declined.


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