Predictors of Emergency Department Use Among Jail Releasees Living With HIV/AIDS Pubblico
Ibeson, Emeka (2014)
Abstract
The socioeconomic and public health relevance of HIV/AIDS remains a global health issue in the 21st century. People incarcerated constitute a significant proportion of individuals living with HIV/AIDS. Incarceration disrupts optimal access to and utilization of health care services. This observational study aims to evaluate the predictors of emergency department use among jail releases living with HIV/AIDS. To understand this relationship, a prospective cohort of 1,078 individuals living with HIV was evaluated in a ten-site demonstration using data from the EnhanceLink project. The study cohort was tracked from time of incarceration to six months post-incarceration. The effect of potential predictors of emergency department use among this population was analyzed. Linkage to care upon release, age at index incarceration, homelessness, pre-incarceration use of the emergency department, lack of medical insurance and mental instability were significantly associated with emergency department use. A holistic perspective involving primary health care provision, mental and socioeconomic rehabilitation is needed to ensure a sustained improvement on the health outcomes of released individuals living with HIV/AIDS. This would lead to a reduction in the transmission of HIV/AIDS and less use of the emergency department.
Table of Contents
TABLE OF CONTENTS
INTRODUCTION1
LITERATURE REVIEW 5
Introduction 5
Health care Utilization and Emergency Department Use 5
Linkage to HIV Care 8
Substance Abuse 10
Housing/Homelessness 12
Medical Insurance 14
Mental Status 15
Conclusion 16
INTRODUCTION TO MANUSCRIPT 18
Hypothesis 18
METHODS19
Sample and Study Design 19
Study Variables 21
Dependent Variable of Interest 21
Independent Variables of Interest 21
Statistical Analysis 23
RESULTS 25
DISCUSSION 28
Study Strengths and Limitations 30
Conclusion 31
Future Directions 32
REFERENCES33
ILLUSTRATIONS
Figure 1: Participants in the EnhanceLink initiative used for the analysis of predictors
of emergency department use six-month post-incarceration 36
Table 1: Descriptive characteristics for study population among those with complete
and incomplete information (N = 1078) 37
Table 2: Univariate analysis: factors associated with emergency department visit
at the end of the six-month post-incarceration (N = 583) 38
Table 3: Multivariate analysis: factors associated with emergency department visit
at the end of the six-month post-incarceration (N = 583) 39
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