Ruth E. Luna-Gierke, Epidemiologist, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA. Yunfeng Tie, Epidemiologist, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA. Xin Yuan, Programmer/Analyst, DLH Corporation, Incorporated, Atlanta, Georgia, USA. Qingwei Luo, Health Scientist, ICF International, Fairfax, Virginia, USA. Linda Beer, Epidemiologist, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA. Sharoda Dasgupta, Epidemiologist, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA.
J Assoc Nurses AIDS Care. 2023;34(5):432-439. doi: 10.1097/JNC.0000000000000420. Epub 2023 Jul 21.
Problems paying medical bills may affect HIV outcomes among people with HIV (PWH), thus limiting progress toward achieving national HIV prevention goals. We analyzed nationally representative data from CDC's Medical Monitoring Project collected during 6/2018-5/2020. Among 8,108 PWH, we reported weighted percentages of characteristics and examined associations between problems paying medical bills and clinical outcomes using prevalence ratios with predicted marginal means, adjusting for potential confounding. Nineteen percent of PWH reported problems paying medical bills. Problems paying medical bills were more prevalent among persons who experienced homelessness (26.9% vs. 18.3%). People with problems paying medical bills were more likely to have adverse HIV outcomes and were more likely to have ≥1 emergency room visit (prevalence ratio [PR]: 1.59; 95% CI [1.51-1.68]) or hospitalization (PR: 1.72; 95% CI [1.55-1.91]) in the past year. Identifying PWH experiencing financial barriers and expanding access to safety net programs could improve access to care and outcomes.
支付医疗费用的问题可能会影响艾滋病毒感染者(PWH)的艾滋病毒结果,从而限制实现国家艾滋病毒预防目标的进展。我们分析了疾病预防控制中心医疗监测项目在 2018 年 6 月至 2020 年 5 月期间收集的具有全国代表性的数据。在 8108 名 PWH 中,我们报告了特征的加权百分比,并使用具有预测边缘均值的患病率比检查了支付医疗费用问题与临床结果之间的关联,调整了潜在的混杂因素。19%的 PWH 报告了支付医疗费用的问题。经历无家可归的人更有可能出现支付医疗费用的问题(26.9%比 18.3%)。有支付医疗费用问题的人更有可能出现不良的艾滋病毒结果,并且更有可能在过去一年中至少有 1 次急诊就诊(患病率比 [PR]:1.59;95%CI [1.51-1.68])或住院治疗(PR:1.72;95%CI [1.55-1.91])。确定有经济障碍的 PWH 并扩大安全网计划的获得渠道,可以改善获得护理和结果的机会。