1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

CARING FOR AIDS PATIENTS: EXPERIENCE COUNTS.

Patients with AIDS who are treated at hospitals with more AIDS cases have better outcomes, according to this cohort study of patients admitted to 40 Massachusetts hospitals in 1987 and 1988.

The investigators identified 300 AIDS patients (half of whom were women, IV drug users, or both) and determined their outcomes from state surveillance records. Inpatient mortality was 13 percent during a total of 806 hospitalizations.

When the hospitals were ranked by experience (i.e., the number of AIDS cases per 10,000 discharges), patients at the 32 hospitals with less AIDS experience were nearly three times more likely to die during their stay than those at the 8 most experienced hospitals. This finding was independent of severity of illness, payer status, HIV transmission mode, and other clinical and economic factors. Patients at low- experience hospitals also had 2.5 times higher 30-day mortality. The better outcomes at high-experience hospitals did not correlate with increased use of resources.

These data are consistent with reports that increased physician experience improves outcomes of patients with diseases other than AIDS.

— THL

Published in Journal Watch General Medicine November 24, 1992

Citation(s):

Stone VE et al. The relation between hospital experience and mortality for patients with AIDS. JAMA 1992 Nov 18 268 2655-2661.

• Medline abstract (Free)