Readmission and death following hospitalization among people with HIV in South Africa

Christopher Hoffmann, Minja Milovanovic, Cody Cichowitz, Anthony Kinghorn, Neil A. Martinson, Ebrahim Variava

Research output: Contribution to journalArticle

Abstract

Background Additional approaches are needed to identify and provide targeted interventions to populations at continued risk for HIV-associated mortality. We sought to describe care utilization and mortality following an index hospitalization for people with HIV in South Africa. Methods We conducted a prospective cohort study among hospitalized patients admitted to medicine wards at a single hospital serving a large catchment area. Participants were followed to 6 months post-discharge. Hospital records were used to describe overall admission numbers and inpatient mortality. Poisson regression was used to assess for associations between readmission or death and independent variables. Results Of 124 enrolled participants, 121 lived to hospital discharge. At the time of discharge the median length of stay of sampled patients was 5.5 days and 105 (87%) participants were referred for follow-up, most within 2 weeks of discharge. By 6 months post-discharge, only 18% of participants had attended the clinic to which they were referred and within the referred timeframe; 64 (53%) had been readmitted at least once and 31 (26%) had died. Self-reported skipping care due to difficulty in access (relative risk 1.3, p = 0.02) and not attending follow-up care on time or at the scheduled clinic or not attending clinic at all (relative risk 1.8 and 2.4, respectively, p = 0.001) were associated with readmission or mortality. Conclusions The post-hospital period is a period of medical vulnerability and high mortality. Improving post-hospital retention in care may reduce post-hospital mortality.

Original languageEnglish (US)
Article numbere0218902
JournalPloS one
Volume14
Issue number7
DOIs
StatePublished - Jan 1 2019

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South Africa
Hospitalization
HIV
death
Mortality
relative risk
Aftercare
Hospital Records
Hospital Mortality
at-risk population
Inpatients
Length of Stay
cohort studies
Cohort Studies
Catchments
Medicine
Prospective Studies
medicine

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Hoffmann, C., Milovanovic, M., Cichowitz, C., Kinghorn, A., Martinson, N. A., & Variava, E. (2019). Readmission and death following hospitalization among people with HIV in South Africa. PloS one, 14(7), [e0218902]. https://doi.org/10.1371/journal.pone.0218902

Readmission and death following hospitalization among people with HIV in South Africa. / Hoffmann, Christopher; Milovanovic, Minja; Cichowitz, Cody; Kinghorn, Anthony; Martinson, Neil A.; Variava, Ebrahim.

In: PloS one, Vol. 14, No. 7, e0218902, 01.01.2019.

Research output: Contribution to journalArticle

Hoffmann, C, Milovanovic, M, Cichowitz, C, Kinghorn, A, Martinson, NA & Variava, E 2019, 'Readmission and death following hospitalization among people with HIV in South Africa', PloS one, vol. 14, no. 7, e0218902. https://doi.org/10.1371/journal.pone.0218902
Hoffmann C, Milovanovic M, Cichowitz C, Kinghorn A, Martinson NA, Variava E. Readmission and death following hospitalization among people with HIV in South Africa. PloS one. 2019 Jan 1;14(7). e0218902. https://doi.org/10.1371/journal.pone.0218902
Hoffmann, Christopher ; Milovanovic, Minja ; Cichowitz, Cody ; Kinghorn, Anthony ; Martinson, Neil A. ; Variava, Ebrahim. / Readmission and death following hospitalization among people with HIV in South Africa. In: PloS one. 2019 ; Vol. 14, No. 7.
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