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The Role of Rapid vs Conventional HIV Antibody Testing for Inpatients
Rapid
testing for 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. In the current study, researchers 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.
The
investigators 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. They then
compared quality-of-care end points for these patients.
Results
· 103
HIV-infected inpatients were identified 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).
Based
on the findings, the authors conclude, “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.”
Division of Infectious Diseases, Department
of Internal Medicine, John H. Stroger, Jr, Hospital of Cook County,
Rush University Medical Center, Ruth M. Rothstein CORE Center, and
Provident Hospital of Cook County, Chicago, Ill.
10/03/05
Reference
R
Lubelchek and others. The Role of Rapid vs Conventional Human Immunodeficiency
Virus Testing for Inpatients: Effects on Quality of Care. Archives
of Internal Medicine 165(17):1956-60. September 26, 2005.
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