Quesenberry C P, Fireman B, Hiatt R A, Selby J V
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611.
Am J Public Health. 1989 Dec;79(12):1643-7. doi: 10.2105/ajph.79.12.1643.
Survival analysis techniques were used in estimating lifetime inpatient utilization among patients diagnosed with acquired immunodeficiency syndrome (AIDS) using data on 863 members of the Kaiser Permanente Medical Care Program in the Northern California Region diagnosed with AIDS between January 1, 1981 and June 30, 1987. Using information on both deceased and living patients, we estimated means of 40.3 lifetime inpatient days and 3.3 hospitalizations among all AIDS patients. Those presenting with Kaposi's sarcoma experienced a mean of 7.6 fewer lifetime inpatient days than those presenting with Pneumocystis carinii pneumonia (95% confidence interval = .61, 14.6) and a mean of 11.0 (3.9, 18.6) fewer inpatient days than all other AIDS patients. Older patients had fewer hospital admissions than younger ones. Year of diagnosis does not appear to be related to lifetime utilization, and there is an indication that increased survival has been accompanied by decreased inpatient utilization intensity as measured on a per person-year basis. We recommend the use of survival analysis methods in the study of utilization among groups of patients with incomplete follow-up.
采用生存分析技术,利用1981年1月1日至1987年6月30日期间北加利福尼亚地区凯撒医疗保健计划中863名被诊断为获得性免疫缺陷综合征(AIDS)患者的数据,估计AIDS患者的终身住院利用率。利用已故和在世患者的信息,我们估计所有AIDS患者的终身住院天数平均为40.3天,住院次数平均为3.3次。患有卡波西肉瘤的患者终身住院天数比患有卡氏肺孢子虫肺炎的患者平均少7.6天(95%置信区间为0.61至14.6),比所有其他AIDS患者的住院天数平均少11.0天(3.9至18.6)。老年患者的住院次数比年轻患者少。诊断年份似乎与终身利用率无关,并且有迹象表明,按每人年计算,生存率的提高伴随着住院利用强度的降低。我们建议在对随访不完全的患者群体的利用情况研究中使用生存分析方法。