Sentell Tetine, Marten Lisa, Ahn Hyeong Jun, Qui Yuanshan, Chen John J, Miyamura Jill, Chow Dominic, Shikuma Cecilia
Office of Public Health Studies, University of Hawai'i at Manoa, John A. Burns School of Medicine, Honolulu, HI (TLS).
Hawaii J Med Public Health. 2014 Oct;73(10):308-14.
Hospitalizations of those living with HIV are expensive and often indicate failures in access to, or retention in, primary care. Higher rates of hospitalizations among individuals with HIV have been reported in some US ethnic minorities, yet little information is available for Native Hawaiians and Asian subgroups. All hospitalizations in Hawai'i of individuals aged ≥13 years from December 2006-December 2010 were considered. Hospitalizations of individuals with HIV were identified using ICD-9 diagnosis codes of 042 and V08; 613 hospitalizations with an HIV diagnostic code were found. Using Hawaii State Department of Health 2010 data, estimated rates of hospitalizations among HIV positive individuals by race/ethnicity among the 2,600 Hawai'i residents living with HIV were calculated along with estimated rate ratios (using Whites as the reference group). Multivariable adjusted estimated rate ratios (aRR) were calculated with negative binomial models, adjusting for age, sex, and payer type. Demographic and clinical differences among hospitalized patients with HIV were also compared by race/ethnicity. Native Hawaiians (aRR: 3.21; 95%CI: 2.11-4.88), Japanese (aRR: 2.27; 95%CI: 1.38-3.72), and Filipinos (aRR: 1.62; 95%CI: 1.01-2.59) living with HIV all had higher likelihood of a hospitalization compared to Whites, even when controlling for age, sex, and payer. Chinese did not vary significantly from Whites. Also of note, the average age of HIV positive individuals who were hospitalized varied significantly across groups (P-value < .001), with Native Hawaiians as the youngest (45 years), followed by Filipinos (47 years), Whites (49 years), Chinese (50 years) and Japanese (54 years). Disparities appear to exist in hospitalizations among HIV positive individuals for Native Hawaiians and Asian subgroups. Further research is warranted to investigate the reasons for these health disparities.
感染艾滋病毒者的住院治疗费用高昂，而且往往表明在获得初级保健或持续接受初级保健方面存在问题。在美国一些少数族裔中，艾滋病毒感染者的住院率较高，但关于夏威夷原住民和亚洲亚群体的信息却很少。研究考虑了2006年12月至2010年12月期间夏威夷所有年龄≥13岁者的住院情况。通过国际疾病分类第九版（ICD - 9）诊断代码042和V08确定艾滋病毒感染者的住院情况；共发现613例有艾滋病毒诊断代码的住院病例。利用夏威夷州卫生部2010年的数据，计算了2600名夏威夷艾滋病毒感染者中按种族/族裔划分的艾滋病毒阳性者的估计住院率以及估计率比（以白人为参照组）。采用负二项式模型计算多变量调整估计率比（aRR），并对年龄、性别和付款人类型进行调整。还按种族/族裔比较了艾滋病毒住院患者的人口统计学和临床差异。与白人相比，感染艾滋病毒的夏威夷原住民（aRR：3.21；95%CI：2.11 - 4.88）、日本人（aRR：2.27；95%CI：1.38 - 3.72）和菲律宾人（aRR：1.62；95%CI：1.01 - 2.59）住院的可能性更高，即使在控制了年龄、性别和付款人因素之后。中国人与白人相比没有显著差异。同样值得注意的是，住院的艾滋病毒阳性者的平均年龄在各群体之间有显著差异（P值<0.001），其中夏威夷原住民最年轻（45岁），其次是菲律宾人（47岁）、白人（49岁）、中国人（50岁）和日本人（54岁）。夏威夷原住民和亚洲亚群体的艾滋病毒阳性者在住院方面似乎存在差异。有必要进行进一步研究以调查这些健康差异的原因。
