Long-term care needs of hospitalized persons with AIDS: a prospective cohort study.
OBJECTIVE
As the treatment for HIV infection has improved, AIDS has become a chronic disease, and the demand for long-term care has increased. The authors studied a cohort of hospitalized persons with AIDS to determine the proportion and characteristics of AIDS patients who could appropriately be cared for in long-term care facilities with skilled nursing.


METHODS
Prospective cohort study.


METHODS
Medical wards of five Seattle tertiary care hospitals.


METHODS
120 consecutive hospitalized persons with AIDS and their primary care physicians, nurses, and social workers.


RESULTS
Appropriateness for long-term care was determined by the patients' physicians, nurses, and social workers. Persons with AIDS who were appropriate for long-term care constituted 32% of the cohort (38 of 120), accounting for 35% of hospital days (11 of these 38 were discharged to long-term care facilities). Four admission characteristics were independently related to appropriateness: impaired activities of daily living, diagnosis of central nervous system illness or poor cognition, living alone, and weight loss. A discriminant function correctly classified over 80% of patients for appropriateness and was developed into a predictive index for planning patient care (sensitivity = 0.74, specificity = 0.85).


CONCLUSIONS
The authors conclude that one-third of hospitalized persons with AIDS may be appropriate for care in long-term care settings, accounting for one-third of the days AIDS patients currently spend in hospitals. These patients can be identified early in hospital stays using a simple predictive index at the bedside.
McCormick
W C
WC
University of Washington, Department of Medicine, Seattle 98195.
Inui
T S
TS
Deyo
R A
RA
Wood
R W
RW
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000328:Adult; D015331:Cohort Studies; D006301:Health Services Needs and Demand; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008134:Long-Term Care; D010347:Patient Care Planning; D010351:Patient Discharge; D011446:Prospective Studies; D012866:Skilled Nursing Facilities; D014861:Washington / Q000453:epidemiology