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Chronic health conditions in Medicare beneficiaries 65 years and older with HIV infection

Filetype[PDF-379.28 KB]



Details:

  • Alternative Title:
    AIDS
  • Description:
    Objectives

    To examine sociodemographic factors and chronic health conditions of people living with HIV (PLWHIV/HIV+) at least 65 years old and compare their chronic disease prevalence with beneficiaries without HIV.

    Design

    National fee-for-service Medicare claims data (parts A and B) from 2006 to 2009 were used to create a retrospective cohort of beneficiaries at least 65 years old.

    Methods

    Beneficiaries with an inpatient or skilled nursing facility claim, or outpatient claims with HIV diagnosis codes were considered HIV+. HIV+ beneficiaries were compared with uninfected beneficiaries on demographic factors and on the prevalence of hypertension, hyperlipidemia, ischemic heart disease, rheumatoid arthritis/osteoarthritis, and diabetes. Odds ratios (OR), 95% confidence intervals (CIs), and P values were calculated. Adjustment variables included age, sex, race/ethnicity, end stage renal disease (ESRD), and dual Medicareā€“Medicaid enrollment. Chronic conditions were examined individually and as an index from zero to all five conditions.

    Results

    Of 29 060 418 eligible beneficiaries, 24 735 (0.09%) were HIV+. HIV+ beneficiaries were more likely to be Hispanic, African-American, male, and younger (P > 0.0001) and were 1.5ā€“2.1 times as likely to have a chronic disease [diabetes (adjusted OR) 1.51, 95% CI (1.47, 1.55):rheumatoid arthritis/osteoarthritis 2.14, 95% CI (2.08, 2.19)], and 2.4ā€“7 times as likely to have 1ā€“5 comorbid chronic conditions [1 condition (adjusted OR) 2.38, 95% CI (2.21, 2.57): 5 conditions 7.07, 95% CI (6.61, 7.56)].

    Conclusion

    Our results show that PLWHIV at least 65 years old are at higher risk of comorbidities than other fee-for-service Medicare beneficiaries. This finding has implications for the cost and health management of PLWHIV 65 years and older.

  • Pubmed ID:
    27478988
  • Pubmed Central ID:
    PMC5086667
  • Document Type:
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