title: The role of rapid vs conventional human immunodeficiency virus testing for inpatients: effects on quality of care.
abstract: BACKGROUND
  Rapid testing for human immunodeficiency virus (HIV) has improved HIV screening in the outpatient and perinatal settings, but few data report how it may be used to improve the quality of inpatient care. We compared quality of care for inpatients diagnosed in the emergency department via rapid testing vs patients whose conditions were diagnosed via conventional testing during their hospital admission.
  
  
  METHODS
  We reviewed medical records to identify patients with first-time positive HIV tests and concurrent hospital admission who were tested via either rapid testing in the emergency department or conventional testing during their hospital admission. We compared quality-of-care end points for these patients.
  
  
  RESULTS
  We identified 103 HIV-infected inpatients with no previous HIV diagnosis; the conditions of 48 patients (47%) were diagnosed by rapid testing and 55 (53%) by conventional testing. Mean length of stay was 6 days for the rapid test group vs 13 days for the conventional test group (P<.001); multivariate regression analysis showed that testing modality had an independent, statistically significant effect on length of stay. Nine (16%) of the patients in the conventional test group vs none in the rapid test group were discharged without receiving their HIV test results (P = .002). Patients in the rapid test group attended the outpatient HIV clinic in a mean of 22 days vs 50 days for the conventional test group patients (P = .05).
  
  
  CONCLUSIONS
  Rapid HIV testing in the emergency department preceding admission may shorten hospital stay, increase the number of newly diagnosed patients with HIV who are discharged from the hospital aware of their HIV status, and improve entry into outpatient care for patients admitted at the time of their initial HIV diagnosis.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, John H. Stroger, Jr, Hospital of Cook County, Chicago, IL 60612, USA. ronald_j_lubelchek@rush.edu
authors.forename: Ronald
authors.initials: R
authors.lastname: Lubelchek
authors.forename: Karen
authors.initials: K
authors.lastname: Kroc
authors.forename: Bala
authors.initials: B
authors.lastname: Hota
authors.forename: Rubina
authors.initials: R
authors.lastname: Sharief
authors.forename: Uma
authors.initials: U
authors.lastname: Muppudi
authors.forename: Joseph
authors.initials: J
authors.lastname: Pulvirenti
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
mesh_terms: D000328:Adult; D019937:Diagnostic Techniques and Procedures; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011787:Quality of Health Care; D012189:Retrospective Studies