A Multicomponent Intervention to Reduce Readmissions Among People With HIV

Area of Science:

• Healthcare Management
• Infectious Diseases
• Public Health

Background:

• Hospital readmissions are a significant concern, impacting costs and patient outcomes, particularly for people with HIV (PWH).
• Multicomponent interventions show promise in addressing preventable readmissions within this population.

Purpose of the Study:

• To evaluate a multicomponent intervention designed to decrease 30-day hospital readmissions among PWH.
• To compare the intervention's effectiveness in PWH versus a control group with cellulitis.

Main Methods:

• A multidisciplinary HIV transitional care team intervention was implemented in an urban safety-net hospital.
• Data on demographic, socioeconomic, and clinical variables were collected from electronic health records before and after intervention implementation (September 2012 to December 2016).
• Multivariate logistic regression and propensity score analyses were used to compare readmission rates.

Main Results:

• The intervention showed a statistically significant reduction in 30-day readmissions for PWH (adjusted odds ratio: 0.81, P=0.04).
• A minimal reduction in readmissions was observed for the control group with cellulitis (adjusted odds ratio: 0.91, P=0.10).
• No dose-response effect was found for the different components of the HIV intervention.

Conclusions:

• A multicomponent transitional care intervention successfully reduced the adjusted risk of 30-day readmissions in people with HIV.
• Further efforts are crucial to enhance HIV prevention, early diagnosis, care engagement, and transitional care services to further decrease hospitalizations and readmissions among PWH.