title: Relation between hospital HIV/AIDS caseload and mortality among persons with HIV/AIDS in Canada.
abstract: OBJECTIVE
  To assess the relation between HIV/AIDS hospital caseload and mortality in Canada.
  
  
  METHODS
  Descriptive, population-based study.
  
  
  METHODS
  All hospitals in Canada that admitted any patients with HIV or AIDS between Mar. 31, 1987, and Apr. 1, 1994.
  
  
  METHODS
  All patients with a diagnostic code on their hospital discharge abstract for HIV infection, AIDS, or with positive serological or viral culture findings for HIV (International Classification of Diseases, 9th revision, 042, 043, 044 or 795.8).
  
  
  METHODS
  In-hospital mortality.
  
  
  RESULTS
  Over the study period, 38,075 admissions attributed to HIV/AIDS (33,380 of men and 4695 of women) were recorded in 513 Canadian hospitals. Of these hospitals, 230 (45%) had fewer than 1 admission per year of patients with HIV/AIDS; 200 (39%) had between 1 and 9; 68 (13%) had between 10 and 99; and 15 (3%) had 100 or more. HIV/AIDS-related admissions ending in death were independently associated with the patient being admitted to lower-volume hospitals, being hospitalized for longer periods of time, and being older, male and at a more advanced stage of disease. During the study period, hospitals with 100 or more admissions per year reported 36% lower mortality among patients with HIV/AIDS than those that had fewer than 1 admission per year.
  
  
  CONCLUSIONS
  There is an inverse relation between hospital caseload and in-hospital mortality among patients with HIV/AIDS in Canada. We attribute this association at least in part to the propensity of high-volume hospitals to deal more effectively with seriously ill patients with HIV/AIDS.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital.
authors.forename: R S
authors.initials: RS
authors.lastname: Hogg
authors.forename: J
authors.initials: J
authors.lastname: Raboud
authors.forename: M
authors.initials: M
authors.lastname: Bigham
authors.forename: J S
authors.initials: JS
authors.lastname: Montaner
authors.forename: M
authors.initials: M
authors.lastname: O'Shaughnessy
authors.forename: M T
authors.initials: MT
authors.lastname: Schechter
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality*; D002170:Canada; D006678:HIV / Q000472:pathogenicity*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D018579:Patient Selection; D011010:Pneumocystis / Q000472:pathogenicity