Outcomes of Dedicated AIDS Units: A Competing Continuation. Abstract, Executive211 Summary and Final Report

摘要

This study (HS 08603-02) extends earlier research (HS 06858) which employed211u001ecomparative, multisite data and a quasi-experimental design to compare inpatient 211u001eoutcomes in 20 hospitals in 11 major cities throughout the United States. The 211u001edata included detailed information on a consecutive sample of AIDS patients 211u001eadmitted to 40 units including interviews, nurses' clinical assessments, 211u001eextensive medical records data, discharge summaries and billing information. The 211u001eauthors' earlier study found that dedicated AIDS units achieved increased patient 211u001esatisfaction and higher job satisfaction and lower burnout for nurses. This study 211u001ehas now extended the patient follow-up period beyond discharge and found positive 211u001eeffects of dedicated AIDS units, and more generally of hospital with dedicated 211u001eAIDS units, on 30-day mortality. It has also demonstrated that organizational 211u001echaracteristics that distinguish dedicated AIDS units from conventional scattered-211u001ebed units, and magnet hospitals from conventionally organized hospitals, are 211u001epartly responsible for favorable patient outcomes, including mortality. Moreover, 211u001eit has more firmly established that a simple four-category scale reflecting 211u001enurses' assessments of patients' need for assistance in basic activities of daily 211u001eliving is a better predictor of mortality than the two more established AIDS 211u001eseverity of illness measures and CD4 counts.