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The Quality of Nursing Homes That Serve Patients With Human Immunodeficiency Virus
Author(s) -
Meyers David J.,
Wilson Ira B.,
Lee Yoojin,
Cai Shubing,
Miller Susan C.,
Rahman Momotazur
Publication year - 2019
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16155
Subject(s) - medicine , medicaid , human immunodeficiency virus (hiv) , population , family medicine , demography , pediatrics , emergency medicine , environmental health , health care , sociology , economics , economic growth
BACKGROUND/OBJECTIVES As the national population of persons living with human immunodeficiency virus (HIV) ages, they will require greater postacute and long‐term care use. Little is known about the quality of nursing homes (NHs) to which patients with HIV are admitted. In this study, we assess the association between the number of persons with HIV admitted annually to a given NH (HIV concentration) and that NH's quality outcomes. DESIGN A cross‐sectional comparative study. SETTING NHs in nine states, from 2001 to 2012. PARTICIPANTS A total of 46 918 NH‐years accounting for 67 301 admissions by patients with HIV. MEASUREMENTS We used 100% Medicaid Analytic Extract, Minimum Dataset 2.0 and 3.0, and Medicare claims from 2001 to 2012 from nine states to examine the association between HIV concentration and NH quality. Persons were classified as HIV positive on the basis of all available data sources, and a NH's percentage of new admissions with HIV was calculated (HIV concentration). We then compared differences in star ratings, rehospitalization rates, NH survey deficiencies, and restraint use by a NH's percentage of admissions with HIV, using linear random effects models. RESULTS After adjusting for NH characteristics, zip code characteristics, and state and year fixed effects, NHs with greater than 0% to 5% of admissions with HIV had a 0.6 lower star rating ( P < .001), and a 0.4% percentage point higher 30‐day rehospitalization rate ( P < .01), compared to those with no HIV admissions. NHs with 5% to 50% of admissions with HIV had 7.0 more deficiencies ( P < .001), a 0.1 lower star rating ( P < .001), and a 1.5 percentage point higher rehospitalization rate ( P < .001). CONCLUSION Persons with HIV were generally admitted to lower‐quality NHs compared to persons without HIV. More efforts are needed to ensure that persons with HIV have access to high‐quality NHs. J Am Geriatr Soc 67:2615–2621, 2019