Organization and outcomes of inpatient AIDS care

Med Care. 1999 Aug;37(8):760-72. doi: 10.1097/00005650-199908000-00006.


Objective: To compare differences in AIDS patients' 30-day mortality and satisfaction with care in dedicated AIDS units, scattered-bed units in hospitals with and without dedicated AIDS units, and in magnet hospitals known to provide good nursing care.

Methods: Data were obtained on 1,205 consecutively admitted patients in 40 units in 20 hospitals and on 820 of their nurses.

Results: Mortality was lower and satisfaction was higher for AIDS patients in dedicated AIDS units and in nursing magnet hospitals. Primary nursing, end-of-life care counseling, and discharge planning were also more common. Higher nurse to patient ratios and AIDS physician specialty services were strongly associated with lower mortality. Patient satisfaction was strongly associated with organizational control of care by bedside nurses. Homosexuals were more likely to be admitted to dedicated AIDS units, which largely explains the under-representation of minorities and women.

Conclusions: Dedicated AIDS units and magnet hospitals offer important benefits to AIDS patients, including lower odds on dying within 30 days of admission, higher patient satisfaction, and care meeting professional standards. Better nurse staffing, AIDS physician specialty services, and more organizational control by bedside nurses improve patient outcomes.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / mortality
  • Acquired Immunodeficiency Syndrome / therapy*
  • Adult
  • Benchmarking
  • Female
  • Hospital Mortality
  • Hospital Units / organization & administration*
  • Hospital Units / standards
  • Humans
  • Male
  • Odds Ratio
  • Outcome and Process Assessment, Health Care / methods
  • Outcome and Process Assessment, Health Care / organization & administration*
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • United States / epidemiology