Am J Psychiatry 1994; 151:1475-1478
Copyright © 1994 by American Psychiatric Association
Psychiatric comorbidity and length of stay in hospitalized AIDS patients
KK Uldall, LA Koutsky, DH Bradshaw, SG Hopkins, W Katon and WE Lafferty
Center for AIDS Research, University of Washington School of Medicine, Seattle.
OBJECTIVE: The purpose of this study was to assess the effect of
psychiatric comorbidity on specific measures of hospital utilization,
including length of stay, among hospitalized AIDS patients. METHOD: Data
collection involved medical record abstraction for AIDS patients admitted
to any one of 19 hospitals in Washington State during 1990. Psychiatric
comorbidity was defined by the presence of an ICD-9 code reflecting
psychiatric illness. Medical/surgical admissions of AIDS patients with
psychiatric diagnoses were compared to those of AIDS patients without
psychiatric diagnoses on measures of mean length of stay for the first
admission in 1990, total number of hospitalizations in 1990, and total
number of hospital days in 1990. Medical morbidity was addressed using CD4+
cell count and current and previous AIDS- defining illnesses as markers of
disease severity. RESULTS: Of 357 patients hospitalized with AIDS, 49 (14%)
had at least one psychiatric diagnosis. Patients with psychiatric illness
were hospitalized an average of 6.6 days longer than AIDS patients without
such illnesses. Differences in medical morbidity did not account for the
longer length of stay. CONCLUSIONS: Psychiatric comorbidity increased the
average length of stay among hospitalized AIDS patients. Future research
needs to address the possible effects of this phenomenon on quality and
cost of care received by AIDS patients.
