Inpatient treatment patterns of human immunodeficiency virus-associated Pneumocystis carinii pneumonia in New York State Medicare patients.
Hospital charts were reviewed to ascertain the frequency with which patients with human immunodeficiency virus (HIV)-associated Pneumocystis carinii pneumonia (PCP) were being managed in accordance with current guidelines or recommendations in New York State for the calendar year 1993. Comparisons were made between hospitals that are designated by the New York State Department of Health as comprehensive treatment centers--designated acquired immunodeficiency syndrome (AIDS) centers--and all other hospitals. For patients who had been on PCP prophylaxis before admission, 34% had documentation of positive histologic evidence for PCP infection during the studied hospitalization period. Of all patients not on PCP prophylaxis at the time of admission, 94% had at least one of the diagnostic tests for PCP done during the PCP hospitalization. Eighty-one percent of all patients had either pulse oximetry or an arterial blood gas determination. Seventy-seven percent of all patients with a PO2 equal to or less than 70 mm Hg received steroids. All eligible patients received one of nine possible treatment combinations, which included either single drug therapy, multiple drug therapy, or participation in a clinical trial. Sixteen percent of eligible patients had no documentation of receiving PCP medication at discharge. Proportions receiving diagnostic or treatment interventions were usually higher in designated AIDS centers than in non-designated AIDS centers.
Silver
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IPRO, Lake Success, NY 10042, USA.
Eichorn
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A
Pickett
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GP
D019072:Antibiotic Prophylaxis; D017723:Drug Utilization Review; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007297:Inpatients; D006278:Medicare / Q000592:standards*; D009518:New York; D010100:Oxygen / Q000097:blood; D010351:Patient Discharge; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D011366:Professional Review Organizations; D014481:United States