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The Role of Rapid vs Conventional Human Immunodeficiency Virus Testing for Inpatients
Effects on Quality of Care
Ronald Lubelchek, MD;
Karen Kroc, BS;
Bala Hota, MD;
Rubina Sharief, MD;
Uma Muppudi, MD;
Joseph Pulvirenti, MD;
Robert A. Weinstein, MD
Arch Intern Med. 2005;165:1956-1960.
Background Rapid testing for human immunodeficiency virus (HIV) has improved HIV screening in the outpatient and perinatal settings, but few data report how it may be used to improve the quality of inpatient care. We compared quality of care for inpatients diagnosed in the emergency department via rapid testing vs patients whose conditions were diagnosed via conventional testing during their hospital admission.
Methods We reviewed medical records to identify patients with first-time positive HIV tests and concurrent hospital admission who were tested via either rapid testing in the emergency department or conventional testing during their hospital admission. We compared quality-of-care end points for these patients.
Results We identified 103 HIV-infected inpatients with no previous HIV diagnosis; the conditions of 48 patients (47%) were diagnosed by rapid testing and 55 (53%) by conventional testing. Mean length of stay was 6 days for the rapid test group vs 13 days for the conventional test group (P<.001); multivariate regression analysis showed that testing modality had an independent, statistically significant effect on length of stay. Nine (16%) of the patients in the conventional test group vs none in the rapid test group were discharged without receiving their HIV test results (P = .002). Patients in the rapid test group attended the outpatient HIV clinic in a mean of 22 days vs 50 days for the conventional test group patients (P = .05).
Conclusions Rapid HIV testing in the emergency department preceding admission may shorten hospital stay, increase the number of newly diagnosed patients with HIV who are discharged from the hospital aware of their HIV status, and improve entry into outpatient care for patients admitted at the time of their initial HIV diagnosis.
Author Affiliations: Division of Infectious Diseases, Department of Internal Medicine, John H. Stroger, Jr, Hospital of Cook County (Drs Lubelchek, Hota, Sharief, Muppudi, and Weinstein), Rush University Medical Center (Drs Lubelchek, Hota, and Weinstein), Ruth M. Rothstein CORE Center (Drs Lubelchek, Hota, Pulvirenti, and Weinstein and Ms Kroc), and Provident Hospital of Cook County (Dr Pulvirenti), Chicago, Ill.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Failure to Return for HIV Test Results: A Pilot Study of Three Community Testing Sites
Grusky et al.
J Int Assoc Physicians AIDS Care (Chic Ill) 2007;6:47-55.
ABSTRACT
An Added Value of Rapid Testing: Improved Quality of Care
AIDS Clin Care 2005;2005:1-1.
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