Inpatient admissions and outpatient visits in persons with and without HIV infection in Denmark, 1995-2007.
OBJECTIVE
HAART has changed morbidity and mortality in the HIV-infected population dramatically. We aimed to estimate the use of healthcare facilities in HIV-infected patients after the introduction of HAART.


METHODS
This is a prospective nationwide cohort study.


METHODS
We identified all Danish HIV patients and a cohort of population controls matched on sex and date of birth. The study period was 1995-2007. We calculated inpatient admission rates and outpatient visit rates stratified by medical speciality and International Classification of Diseases-10 diagnose categories. Relative risks were computed.


RESULTS
Four thousand, seven hundred and sixty HIV-infected patients and 23 800 population controls were identified. Overall inpatient admission rates [95% confidence interval (CI)] for HIV-infected patients decreased from 90 (88-93) to 57 (56-58)/100 person-years in the study period. The risk ratio (95% CI) fell from 6.2 (6.0-6.5) to 3.1 (3.1-3.2) predominantly due to reduced inpatient admission rates to departments of infectious diseases. The overall outpatient visit rates (95% CI) for the HIV-infected patients increased from 744 (737-751) to 877 (872-882)/100 person-years, mainly due to visits at departments other than infectious diseases. A marked increase in outpatient visit rates (95% CI) in the background population decreased the risk ratio from 16.5 (16.2-16.8) to 7.1 (7.0-7.2). We observed a decreased relative risk of inpatient admissions and outpatient visits due to cancers and a small increase in relative risk due to cardiovascular disease.


CONCLUSIONS
After the introduction of HAART, the inpatient treatment of HIV-infected patients has decreased, especially at departments of infectious disease. In contrast, this population's use of outpatient facilities has increased in noninfectious disease specialities.
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK2100 Copenhagen Ø, Denmark. fren74@gmail.com
Frederik Neess
FN
Engsig
Ann-Brit Eg
AB
Hansen
Jan
J
Gerstoft
Gitte
G
Kronborg
Carsten Schade
CS
Larsen
Niels
N
Obel
D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D003718:Denmark / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011446:Prospective Studies