Alcohol problems and health care services use in human immunodeficiency virus (HIV)-infected and HIV-uninfected veterans

Med Care. 2006 Aug;44(8 Suppl 2):S44-51. doi: 10.1097/01.mlr.0000223703.91275.78.

Abstract

Background: Although alcohol problems are common in human immunodeficiency virus (HIV)-infected patients, their impact on health care services use in HIV-infected patients is not well understood.

Objective: We sought to examine the association between alcohol problems and health care services use in HIV-infected and HIV-uninfected patients.

Design, setting, and subjects: We undertook a prospective analysis of 16,048 HIV-infected veterans and 32,096 age-, race-, gender-, and region-matched HIV-uninfected controls identified through the national Veterans Affairs electronic administrative medical record database. We identified subjects with alcohol problems using ICD-9-CM codes for alcohol diagnoses and/or alcohol-related complications.

Main outcome measures: We measured outpatient visits, emergency department visits, and inpatient hospitalizations over 12 months of follow-up.

Results: In adjusted analyses, HIV-infected veterans with alcohol problems were significantly more likely than HIV-uninfected veterans without alcohol problems to have at least 1 outpatient visit and at least 1 inpatient hospitalization and, among those with any health services use, to have significantly greater rates for outpatient visits (Incidence rate ratio [IRR] 2.17; 95% confidence interval [CI] 2.06-2.28; P < 0.001), emergency department visits (IRR 1.46; 95% CI 1.35-1.58; P < 0.001), and inpatient hospitalizations (IRR 1.46; 95% CI 1.30-1.64; P < 0.001). The incidence rates for outpatient visits, mental health visits, emergency department visits, and inpatient hospitalizations were significantly higher in HIV-infected veterans with alcohol problems than in HIV-infected veterans without alcohol problems. We did not find a consistent interaction effect between alcohol problems and HIV status.

Conclusion: Alcohol problems are associated with greater outpatient, emergency department, and inpatient health care utilization in HIV-infected and HIV-uninfected veterans. However, alcohol does not appear to have a stronger effect on health services use in HIV-infected veterans compared with HIV-uninfected veterans.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcoholism / complications*
  • Cohort Studies
  • Female
  • HIV Seropositivity*
  • Health Services / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Texas
  • Veterans*