AEGiS-15IAC: A four-year surveillance study of hospitalization needs of HIV/AIDS patients at an Infectious Disease (ID) reference centre.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

A four-year surveillance study of hospitalization needs of HIV/AIDS patients at an Infectious Disease (ID) reference centre.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10243)

Manfredi R, Calza L, Chiodo F
Infectious Diseases, University of Bologna, Bologna, Italy

BACKGROUND: Notwithstanding the HAART-related change of natural history of HIV,the hospitalization potential of ID wards remains inadequate,according to the continue modification of epidemiology and disease spectrum.

METHODS: A surveillance study of patients (p) needing hospitalization at our ward and their outcome,was carried out since 4 years. From 1/2000 to 5/2003 our inpatient unit could rely on 16 beds (8 rooms),while since 6/2003 (after joining with the other ID unit of our 700000-inhabitant metropolitan area),beds rose to 35 (18 rooms). The ID specialist has to act as a consultant for every p with a suspected ID,to assess need of hospitalization-isolation,and eventually search an adequate place,when beds are not available at our ward.

RESULTS: The rate of p admitted elsewhere dropped from 2000 (34.3%),to 2001 (26.9%),2002 (12.9%),reaching a plateau in 2003 (12.7%;p<.0001 vs 2000). Among the 481 p who could not be admitted by us,no epidemiological differences were found during time,and HIV disease predominated (233 p:48.4%). When infectious (but not diffusive) illnesses were of concern,p were accepted by other Hospital wards or other city Hospitals,while the event of diffusive ID required a transfer to the closest ID ward. Until 5/2002,the other city ID Unit accepted >30% of p,but the unification into a single Division partially reduced the need of transferts 40-115 Km far,stabilizing the rate around 13% in the last 2 years. Among the 233 HIV p not accepted at our ward,27.5% had a place at the other ID ward,57.5% at our Hospital,4.7% at Hospitals of Bologna province,while 10.3% needed a transfer to other cities.

CONCLUSION: ID wards still play a key role,although a continuous fitting to prevailing ID and available resources is needed. The lack of suitable beds for p needing admission remains a notable problem,especially when p with acute-severe illnesses are of concern,and a long-distance transfert may result in risks for p health,and maintenance of isolation meaures

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Communicable Diseases, Health Services Needs and Demand, Hospitalization, HIV Infections, Antiretroviral Therapy, Highly Active, Health Resources, Time, Hospital Units, Risk Management, Patient Isolation, Infection Control, Hospitals, Humans, epidemiology, economics

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B10243