RT Journal Article
SR Electronic
T1 Emergency department use by people with HIV in Ontario: a population-based cohort study
JF CMAJ Open
FD Canadian Medical Association
SP E240
OP E248
DO 10.9778/cmajo.20150087
VO 4
IS 2
A1 Ryan Ng
A1 Claire E. Kendall
A1 Ann N. Burchell
A1 Ahmed M. Bayoumi
A1 Mona R. Loutfy
A1 Janet Raboud
A1 Richard H. Glazier
A1 Sean Rourke
A1 Tony Antoniou
YR 2016
UL http://www.cmajopen.ca/content/4/2/E240.abstract
AB Background: Emergency department use may reflect poor access to primary care. Our objective was to compare rates and causes of emergency department use between adults living with and without HIV.Methods: We conducted a population-based study involving Ontario residents living with and without HIV between Apr. 1, 2011, and Mar. 31, 2012. We frequency matched adults with HIV to 4 HIV-negative people by age, sex and census division, and used random-effects negative binomial regression to compare rates of emergency department use. We classified visits as low urgency or high urgency, and also examined visits for ambulatory care sensitive conditions. Hospital admission following an emergency department visit was a secondary outcome.Results: We identified 14 534 people with HIV and 58 136 HIV-negative individuals. Rates of emergency department use were higher among people with HIV (67.3 v. 31.2 visits per 100 person-years; adjusted rate ratio 1.58, 95% confidence interval [CI] 1.51-1.65). Similar results were observed for low-urgency visits. With the exception of hypertension, visit rates for ambulatory care sensitive conditions were higher among people with HIV. People with HIV were also more likely than HIV-negative individuals to be admitted to hospital following an emergency department visit (adjusted odds ratio 1.55, 95% CI 1.43-1.69).Interpretation: Compared with HIV-negative individuals, people with HIV had high rates of emergency department use, including potentially avoidable visits. These findings strongly support the need for comprehensive care for people with HIV.