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Trends in Comorbid Conditions Among Medicaid Enrollees With HIV
- Source :
- Open Forum Infectious Diseases
- Publication Year :
- 2019
- Publisher :
- Oxford University Press (OUP), 2019.
-
Abstract
- Background As antiretroviral therapy has become more effective, persons with HIV live longer and develop conditions that are characteristic of older populations. Understanding changes in comorbid conditions has important implications for the complexity and cost of care, particularly for Medicaid programs and their enrollees, which comprise about 40% of all persons with HIV. Thus, our objective was to examine trends in comorbid conditions for Medicaid enrollees with HIV. Methods Using 2001–2012 administrative claims data from the 14 states (NY, CA, FL, TX, MD, NJ, PA, IL, GA, NC, VA, LA, OH, MA) with the highest HIV prevalence, we identified 494 322 unique Medicaid enrollees with HIV, representing 5.8 million person-quarters after exclusions. We estimated changes over time in enrollee characteristics, proportions of enrollees with the 10 most common comorbid conditions, and number of comorbid conditions per enrollee. Results Over time, the average age for HIV Medicaid enrollees increased, and the proportion enrolled in a managed care plan also increased. In 2012, the highest proportion of enrollees exhibited evidence of hypertension (31%), psychiatric disease (26%), any liver disease (25%), and pulmonary disorder (23%). Nine of the 10 comorbid conditions increased over time, whereas HIV-related conditions declined. The largest adjusted relative increases in 2012 vs 2003 were observed for renal insufficiency (adjusted odds ratio [aOR], 2.20; P < .001), hyperlipidemia (aOR, 1.80; P < .001), and psychiatric disease (aOR, 1.45; P < .001). Conclusions Despite improvements in antiretroviral therapy and better control of patients’ HIV, we found substantial increases in rates of comorbid conditions over time. These findings have important implications for the complexity and costs of clinical care and for state Medicaid programs.
- Subjects :
- 0301 basic medicine
comorbid conditions
030106 microbiology
Human immunodeficiency virus (HIV)
medicine.disease_cause
Older population
03 medical and health sciences
0302 clinical medicine
Major Article
Medicine
030212 general & internal medicine
Psychiatric Disease
Medicaid
business.industry
aging
HIV
Odds ratio
medicine.disease
Comorbidity
3. Good health
Infectious Diseases
Oncology
Managed care
business
Cost of care
Demography
Subjects
Details
- ISSN :
- 23288957
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Open Forum Infectious Diseases
- Accession number :
- edsair.doi.dedup.....970d04807289549f5a3a5082427f583b