エイズ患者の入院経験と死亡率の関係

V E Stone¹, G R Seage, T Hertz

¹Department of Medicine, Boston City Hospital, Boston University School of Medicine, MA.

JAMA

|November 18, 1992

まとめ

既得免疫不全症候群 (AIDS) 患者の治療経験が少ない病院では,死亡率が高かった. この増加したリスクは,患者の疾患の重症度や資源利用の違いによるものではなかった.

科学分野:

公衆衛生は公衆衛生である.
エピデミオロジーエピデミオロジー
ヘルスケア・マネジメント・ヘルスケア・マネジメント

背景:

既得免疫不全症候群 (AIDS) は,専門的なケアを必要とする複雑な状態です.
エイズとの病院での経験の変動は,患者の結果に影響を与える可能性があります.

研究の目的:

病院でのエイズ体験と患者の死亡率との関連を調査する.
疾患の重症度,排出パターン,または資源使用が,この関連性を説明するかどうかを判断する.

主な方法:

マサチューセッツ州 (1987) のエイズ入院に関する州全体のコホート研究.
40の病院で806件の入院が含まれる.
分析された入院および30日間の死亡率,入院期間,集中治療室での使用.

主要な成果:

エイズ経験が低い病院では,入院患者の死亡率が2.16倍高い.
複数の要因を考慮した結果,エイズの経験が低いことが有意な予測因子となった (RR 2.92).
また,経験が少ない病院では,入院期間が長くなり,ICUの利用率が高かった.

結論:

エイズ患者の死亡率は,エイズの経験が少ない病院では著しく高い.
この格差は,患者の重症度,退院の慣行,またはリソースの強度の違いによるものではありません.

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