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HIV/AIDS length of stay in Portugal under financial constraints: a longitudinal study for public hospitals, 2009–2014

2019-05-10Journal article Open access
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datacite.subject.fosCiências Médicas::Medicina Clínica
datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorAugusto, Gonçalo
dc.contributor.authorAbrantes, Alexandre V.
dc.contributor.authorMartins, Maria R.
dc.contributor.authorDias, Sara
dc.date.accessioned2025-12-09T21:03:15Z
dc.date.available2025-12-09T21:03:15Z
dc.date.issued2019-05-10
dc.description.abstractThe global financial crisis and the economic and financial adjustment programme (EFAP) forced the Portuguese government to adopt austerity measures, which also included the health sector. The aim of this study was to analyse factors associated with HIV/AIDS patients' length of stay (LOS) among Portuguese hospitals, and the potential impact of the EFAP measures on hospitalizations among HIV/AIDS patients. METHODS: Data used in this analysis were collected from the Portuguese database of Diagnosis Related Groups (DRG). We considered only discharges classified under MCD 24 created for patients with HIV infection. A total of 20,361 hospitalizations occurring between 2009 and 2014 in 41 public hospitals were included in the analysis. The outcome was the number of days between hospital admission and discharge dates (LOS). Hierarchical Poisson regression model with random effects was used to analyse the relation between LOS and patient, treatment and setting characteristics. To more effectively analyse the impact of the EFAP implementation on HIV/AIDS hospitalizations, yearly variables, as well as a variable measuring hospitals' financial situation (current ratio) was included. RESULTS: For the 5% level, having HIV/AIDS as the principal diagnosis, the number of secondary diagnoses, the number of procedures, and having tuberculosis have a positive impact in HIV/AIDS LOS; while being female, urgent admission, in-hospital mortality, pneumocystis pneumonia, hepatitis C, and hospital's current ratio contribute to the decrease of LOS. Additionally, LOS between 2010 and 2014 was significantly shorter in comparison to 2009. Differences in LOS across hospitals are significant after controlling for these variables. CONCLUSION: Following the EFAP, a number of cost-containment measures in the health sector were implemented. Results from our analysis suggest that the implementation of these measures contributed to a significant decrease is LOS among HIV/AIDS patients in Portuguese hospitalseng
dc.description.sponsorshipAcknowledgements The authors wish to thank the Central Administration of the Health System (ACSS, Administração Central do Sistema de Saúde), which provided the data, and FCT (Fundação para a Ciência e Tecnologia) for funds to GHTM – UID/Multi/04413/2013. Funding This study had no funding.
dc.identifier.citationAugusto, G. F., Dias, S. S., Abrantes, A. V., & Martins, M. R. O. (2019). HIV/AIDS length of stay in Portugal under financial constraints: A longitudinal study for public hospitals, 2009–2014. BMC Health Services Research, 19, 303. https://doi.org/10.1186/s12913-019-4131-0
dc.identifier.doi10.1186/s12913-019-4131-0
dc.identifier.issn1472-6963
dc.identifier.urihttp://hdl.handle.net/10400.8/14966
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSpringer Science and Business Media
dc.relationUID/Multi/04413/2013.
dc.relation.hasversionhttps://link.springer.com/article/10.1186/s12913-019-4131-0
dc.relation.ispartofBMC Health Services Research
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAusterity
dc.subjectHIV/AIDS
dc.subjectHospitals
dc.subjectLOS
dc.subjectPortugal
dc.subjectInfectious Diseases
dc.subjectEnvironmental and Occupational Health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleHIV/AIDS length of stay in Portugal under financial constraints: a longitudinal study for public hospitals, 2009–2014eng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1
oaire.citation.startPage303
oaire.citation.titleBMC Health Services Research
oaire.citation.volume19
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameDias
person.givenNameSara
person.identifier.ciencia-idAA1F-9375-B5E6
person.identifier.orcid0000-0001-6782-7481
person.identifier.ridI-9965-2018
person.identifier.scopus-author-id33367487300
relation.isAuthorOfPublicationa49e0bc6-cfea-4033-aebf-a1ef9e4c5e7b
relation.isAuthorOfPublication.latestForDiscoverya49e0bc6-cfea-4033-aebf-a1ef9e4c5e7b

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