Outcomes of Dedicated AIDS Units. Abstract, Executive Summary and Final Report

摘要

Two discrete models for organizing inpatient AIDS care have emerged as hospitalsresponded to the AID epidemic; dedicated AIDs units and scattered-beds located on multidiagnosis medical units. The degree to which AIDS care should be rendered in setting that segregate patients from the medical mainstream continues to be debated. Concerns about quality of care and wwwient satisfaction on specialized AIDS units persist. Results are provided from the first large-scale multihospital study of dedicated units. A number of benefits of dedicated AIDS units are found including higher patient satisfaction, greater patient preference for care on dedicated units, and lower nurse burnout. There is no evidence that specialized AIDS units adversly affect care as was feared early in the epidemic. A major part of our research has been the evaluation of four methods for measuring severity of illness among AIDS inpatients. We show that a simple four category scale reflecting nurses' assessments of patients' need for assistance in basic activities of daily living is a better predictor of in-hospital mortality than the two more established AIDS severity of illness measures and CD4 counts. The use of this measure could facilitate the assessment of the effectiveness of inpatient AIDS interventions.