Historique
Périodique
Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders
(Prédicteurs de l'utilisation des services médicaux par des individus usagers de drogues et infectés par le VIH)
Auteur(s) :
MASSON, C. L. ;
SORENSEN, J. L. ;
PHIBBS C. S. ;
OKIN R. L.
Année
2004
Page(s) :
744-755
Langue(s) :
Anglais
Refs biblio. :
49
Domaine :
Drogues illicites / Illicit drugs
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Thésaurus mots-clés
VIH
;
USAGER
;
ACCES AUX SOINS
;
FACTEUR DE RISQUE
;
TRAITEMENT AMBULATOIRE
;
URGENCE
;
HOSPITALISATION
Note générale :
AIDS Care, 2004, 16, (6), 744-755
Note de contenu :
tabl.
Résumé :
ENGLISH :
This study examined factors affecting medical service use among HIV infected persons with a substance abuse disorder. The sample comprised 190 participants enrolled in a randomized trial of a case management intervention. Participants were interviewed about their backgrounds, housing status, income, alcohol and drug use problems, health status and depressive symptoms at study entry. Electronic medical records were used to assess medical service use. Poisson regression models were tested to determine the effects of need, enabling and predisposing factors on the dependent variables of emergency department visits, inpatient admissions and ambulatory care visits. During a two year period, 71 % were treated in the emergency department, 64% had been hospitalized and the sample averaged 12.9 ambulatory care visits. Homelessness was associated with higher utilization of emergency department and inpatient services; drug use severity was associated with higher inpatient and ambulatory care service use; and alcohol use severity was associated with greater use of emergency medical services. Homelessness and substance abuse exacerbate the health care needs of HIV infected persons and result in increased use of emergency department and inpatient services. Interventions are needed that target HIV infected persons with substance abuse disorders, particularly those that increase entry and retention in outpatient health care and thus decrease reliance on acute hospital-based services. (Author' s abstract)
Affiliation :
Univ. California, San Francisco at San Francisco General Hospital, Dept Psychiatry, 1001 Potrero Ave., San Francisco, CA 94110. E-mail: massonitsa.ucsf.edu
Etats-Unis. United States.
Etats-Unis. United States.