The Impact of Drug Users on Inpatient Hospital Care during the Human Immunodeficiency Virus Epidemic in Amsterdam

Haastrecht, H. J. A. Van; Bindels, Patrick J E; Sluijs, Theo A; Hoek, A. A. R. Van Den; Reijneveld, Sijmen A.; Coutinho, Roel A.

doi:10.1093/ije/25.4.846

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…In these days a relatively small proportion of the Amsterdam general hospital beds were occupied by HIV infected drugs users [14]. As a result of lifestyle concerns and strict admissions criteria, aftercare for this group was not offered by the mainstream nursing homes.…”

Section: Introductionmentioning

confidence: 99%

Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

Laere

Wit²,

Klazinga

2009

BMC Health Serv Res

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BackgroundAdequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam.MethodsDemographics of ill homeless adults, diagnoses, referral pattern, length of stay, discharge locations, and mortality, were collected by treating physicians during outreach care provision in a shelter-based convalescence care facility in Amsterdam, from January 2001 through October 2007.Results629 individuals accounted for 889 admissions to the convalescence care facility. 83% were male and 53% were born in the Netherlands. The mean age was 45 years (SD 10 years). The primary physical problems were skin disorders (37%), respiratory disorders (33%), digestive disorders (24%) and musculoskeletal disorders (21%). Common chronic conditions included addictions 78%, mental health disorders 20%, HIV/AIDS 11% and liver cirrhosis 5%. Referral sources were self-referred (18%), general hospitals (21%) and drug clinics (27%). The median length of stay was 20 days. After (self)discharge, 63% went back to the previous circumstances, 10% obtained housing, and 23% went to a medical or nursing setting. By March 2008, one in seven users (n = 83; 13%) were known to have died, the Standard Mortality Ratio was 7.5 (95% CI: 4.1-13.5). Over the years, fewer men were admitted, with significantly more self neglect, personality disorders and cocaine use. Lengths of stay increased significantly during the study period.ConclusionOver the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available.

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Section: Introductionmentioning

confidence: 99%

Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

Laere

Wit²,

Klazinga

2009

BMC Health Serv Res

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“…Minimizing length of stay (LOS) for hospitalized patients infected with AIDS without reducing quality of care or increasing frequency of hospitalization is desirable. Besides being expensive (Van Haastrecht et al 1996), hospitalization days put AIDS patients at risk for nosocomial infections and disrupt their economic and social lives. To this end, many studies have found substantial (i.e., of two to four days) reductions in hospital LOS for patients infected with HIV have occurred since the mid‐1980s (Grabau, Kaufman, and Han 1991; Markson, Turner, and Fanning 1992; Paul et al 1999; Kelly, Ball, and Turner 1989; Stein 1994; Bonuck and Arno 1997).…”

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confidence: 99%

Mental Illness and Length of Inpatient Stay for Medicaid Recipients with AIDS

Hoover

Sambamoorthi²,

Walkup³

et al. 2004

Health Services Research

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Objective. To examine the associations between comorbid mental illness and length of hospital stays (LOS) among Medicaid beneficiaries with AIDS. Data Source and Collection/Study Setting. Merged 1992–1998 Medicaid claims and AIDS surveillance data obtained from the State of New Jersey for adults with ≥1 inpatient stay after an AIDS diagnosis from 1992 to 1996. Study Design. Observational study of 6,247 AIDS patients with 24,975 inpatient visits. Severe mental illness (SMI) and other less severe mental illness (OMI) diagnoses at visits were ascertained from ICD–9 Codes. About 4 percent of visits had an SMI diagnosis; 5 percent had an OMI diagnosis; 43 percent did not have a mental illness diagnosis, but were patients who had been identified as having an SMI or OMI history; and 48 percent were from patients with no identified history of mental illness. Principal Findings. The overall mean hospital LOS was 12.7 days. After adjusting for measures of HIV disease severity and health care access in multivariate models, patients presenting with primary and secondary severe mental illness (SMI) diagnoses had ∼32 percent and ∼11 percent longer LOS, respectively, than did similar patients without a mental illness history (p<0.001 for each). But in these adjusted models of length of stay: (1) diagnosis of OMI was not related to LOS, and (2) in the absence of a mental illness diagnosed at the visit, an identified history of either SMI or OMI was also not related to LOS. In adjusted models of time to readmission for a new visit, current diagnosis of SMI or OMI and in the absences of a current diagnosis, history of SMI or OMI all tended to be associated with quicker readmission. Conclusions. This study finds greater (adjusted) LOS for AIDS patients diagnosed with severe mental illness (but not for those diagnosed with less severe mental comorbidity) at a visit. The effect of acute severe mental illness on hospitalization time may be comparable to that of an acute AIDS opportunistic illness. While previous research raises concerns that mental illness increases LOS by interfering with treatment of HIV conditions, the associations here may simply indicate that extra time is needed to treat severe mental illnesses or arrange for discharge of afflicted patients.

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Factors Associated with Hospitalization for Blood-Borne Viral Infections Among Treatment-Seeking Illicit Drug Users

Onyeka

Olubamwo

Beynon

et al. 2015

Journal of Substance Abuse Treatment

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The Impact of Drug Users on Inpatient Hospital Care during the Human Immunodeficiency Virus Epidemic in Amsterdam

Abstract: On the total scale of inpatient hospital expenditure in Amsterdam, the contribution of illicit drug users appears to be small.

Cited by 6 publications

References 14 publications

Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

Mental Illness and Length of Inpatient Stay for Medicaid Recipients with AIDS

Factors Associated with Hospitalization for Blood-Borne Viral Infections Among Treatment-Seeking Illicit Drug Users

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