2065. HIV/AIDS In The VA: Care Utilization and Disease Burden
Henry K Tam, PhD, QUERI-HIV, VA San Diego Healthcare System, A Schepps, QUERI-HIV, VA San Diego Healthcare System, SA Bozzette, QUERI-HIV, VA San Diego Healthcare System

Objectives: To describe the trends in care utilization and disease burden among HIV/AIDS patients in the Veterans Health Administration.

Methods: This description of the cohort was achieved by merging administrative data from the VA Immunology Case Registry (ICR) with other VA national datasets and non-VA datasets.

Results: Over 38,000 patients received HIV care in the VA between 1993 and 2001. The median age of this cohort is 41. While total encounters at primary care or infectious disease clinics have remained steady, the frequency of these encounters have declined from once every 9 weeks in 1993 to once every 15 weeks in 2001. The proportion of patients under antiretroviral treatment who were on a recommended HAART combination was 15% in 1996 and up to 60% in 2001. There were over 18,000 hospital stays in 1993 compared to just fewer than 4000 stays in 2001. While this drop was observed for hospitalization of all diagnoses, a decline in hospital stays where an AIDS-related condition was the primary discharge diagnosis was most evident. Finally, AIDS-related conditions were identified as the cause in 27% of all deaths in 1993 and 13% in 1998.

Conclusions: The rapid uptake of highly active antiretroviral therapy combined with declines in inpatient and outpatient service utilization suggests the VHA has been successful in treating and lowering the disease burden of HIV-infected patients.

Impact: It is important to continue monitoring trends in the care of this patient population and the impact of quality care on their disease burden.