Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-30T20:28:27.713Z Has data issue: false hasContentIssue false
  • English
  • Français

Migration to Rural Areas by HIV Patients Impact on HIV-Related Healthcare Use

Published online by Cambridge University Press:  21 June 2016

Kristine Davis  and
Jack Stapleton
Kristine Davis
Affiliation:
Department of Nursing, Iowa City, Iowa
Jack Stapleton*
Affiliation:
Department of Internal Medicine, Iowa City, Iowa
*
Department of Internal Medicine, Division of Infectious Diseases, University of Iowa, Iowa City, IA 52242
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate the impact of patient migration on human immunodeficiency virus (HIV)-related healthcare use in a rural setting.

Design:

Data were collected on all patients seeking medical care related to HIV infection at The University of Iowa HIV/acquired immunodeficiency syndrome (AIDS) clinic. Information was collected related to patient care, stage of illness, prior and current residence, and clinic and hospital use.

Setting:

An outpatient clinic in a university hospital offering primary and consultative medical care for persons with HIV infection.

Patients:

All patients scheduled into clinic reported a previous positive HIV serologic test.

Results:

Forty-five percent (81 of 181) of patients reported moving to Iowa, yet no more than 11% (n = 20) moved out of the state during the same period of observation. Of patients meeting the centers for Disease control criteria for AIDS, 24% were diagnosed prior to moving to Iowa (18 of 74). Twenty-seven percent of AIDS-related inpatient days of hospitalization and 19% of AIDS-related outpatient clinic visits were used by persons diagnosed in another state. Lifetime charges totalled for eight patients ranged from $24,873 to $232,556, with a mean of $109,934.

Conclusions:

A substantial portion of HIV related healthcare in our rural area was used by individuals who had migrated to or back to Iowa. Further understanding of the reasons for and the extent of HIV patient migration to rural areas is needed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 9 , September 1991 , pp. 540 - 543
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Centers for Disease Control. Update: acquired immunodeficiency syndrome-United States, 1989. MMWR. 1990;35:81–86.Google Scholar
2. Centers for Disease Control. Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR. 1987;36:Google Scholar
3. Centers for Disease Control. Classification system for HTLV-III/ LAV infections. MMWR. 1986;35:334–339.Google Scholar
4. Redfield, RR. The Walter Reed staging classification for HTLV/ LAV infection. N Engt J Med. 1986;314:131–132.Google Scholar
5. AIDS Cases-Zowa. Des Moines, Ia: Iowa Department of Health; January 31, 1990.Google Scholar
6. Karon, JM, Dondero, TJ, Curran, JW. The projected incidence of AIDS and estimated prevalence of HIV infection in the United States. J Acquir Immune Defic Syndr. 1988;1:542–550.Google Scholar
7. Gardner, LI, Brundage, JF, Burke, DS, McNeil, JG, Visintine, R, Miller, RN. Evidence for spread of the human immunodeficiency virus epidemic into low prevalence areas of the United States. J Acquir Immune Defic Syndr. 1989;2:521–532.Google Scholar
8. Salzberg, AM, Dolins, SL. The relation between AIDS cases and HIV prevalence. N Engl J Med. 1989;320:936.Google Scholar
9. Hoffman, RE, Valway, SE, Wolf, FC, et al. Comparison of AIDS and HIV antibody surveillance data in Colorado. J Acquir Immune Defic Syndr. 1989;2:194–200.Google Scholar
10. Burda, D. Specialty hospitals: small and rurals await impending AIDS crisis. Hospitals. 1986;71–72.Google Scholar
11. Patton, M. The virus in our midst. W Vu Med J. 1989;85:92–97.Google Scholar
12. Trotter, JA, Haglund, LA, Greenfield, RA, et al. Clinical experience with HIV-infected patients at the University of Oklahoma Health Sciences Center. J Okla State Med Assoc. 1989;82 257–261.Google Scholar
13. Vergese, A, Berk, SL, Sarubbi, F. Urbs in rare: human immunode-ficienccy virus infection in rural Tennessee. J Infect Dis. 1989;160:1051–1055.Google Scholar
14. Rowe, M, Keintz, R. National survey of state spending for AIDS. George Washington University Intergovernmental AIDS Reports. 1989;2:1–10.Google Scholar
15. Hardy, AM, Rauch, K, Echenberg, D, Morgan, WM, Curran, JW. The economic impact of the first 10,060 cases of acquired immunodeficiency syndrome in the United States. JAMA. 1986;255:209–211.Google Scholar
16. Hiatt, RA, Quesenberry, CP, Selby, JV, Fireman, BH, Knight, A. The cost of acquired immunodeficiency syndrome in northern California. Arch Intern Med. 1990;150:833–838.Google Scholar
17. Kizer, K, Keith, J, Hiehle, J, Wolcott, C, Maxfield, WT. AZDS in California. Expenditures, Demographics, and Mortality for People With AIDS on MediCal. Sacramento, Calif: Department of Health Services, California; December 1988.Google Scholar