Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Track B: Clinical Science

Tu.B.2135 -Tu.B.2139

Conclusions: Minor differences in the Vd and/or CLT of d4T were observed for gender or
for race, but are considered clinically unimportant.The interaction between d4T and acyclovir is consistent with competition for renal tubular secretion, but was not considered to
warrant dose adjustment.
Thaddeus H. Grasela, Pharmaceutical Outcomes Research, Inc., 4 5 Lawrence Bell Dr:, Suite
7,Williamsville, NY 14221 Telephone: [phone] Fax: 716-6,'-7404 email:
[email protected]
Tu.B.2135
HOSPITAL EXPERIENCE OF PERSONS WITH HIV INFECTION IN BELGIUM
Depraetere, Katrien**, Fleerackers Y*, Koeck R*, De Roo A*, Pelgrom J*, Colebunders
Robert**,*. *Institute ofTropical Medicine, Antwerp, Belgium; *University Hospital
Antwerp, Edegem, Belgium.
Objective:To evaluate the quality of care for per sons with HIV infection in Belgian hospitals.
Methods: An anonymous questionnaire survey was organised anrig persons with HIV
infection in Belgium, known to be HIV seropositive since at least 3 months. Questionnaires
were distributed in and outside health care settings. Patients, 74% men and 26% women,
who had been hospitalized at least once since they were diagnosed with HIV infection,
were enrolled in the study Fifty nine percent were homosexual men, 14% were heterosexual men, I 6% were heterosexual women, 5% were infected through IV drug use.
Results: 35% had been hospitalized in a general hospital, 65% in a university hospital; 48% in
a single room, 33% in a two-bed room, 19% in a room with more than 2 beds.The hospital
ward was described as a specialized service for HIV (49%), a service where occasionally
persons with HIV were admitted (20%), another service (28%). Most patients had no major
complaints concerning the hospital care. Complaints included: insufficient information about
their health status (1I8%), physicians are not spending enough time with patients (23%),
treatment (23%) and investigational procedures (26%) were insufficiently discussed, patronizing by nurses (29%), bad hospital meals (24%), long waiting times for investigational procedures (21%). II % felt they had been hospitalized too long. 50 patients reported that they
met another person with HIV infection during hospitalisation. 64% had experienced this
contact as supportive, but in 36% it had increased their anxiety.
Conclusions: Most persons with HIV infection who have been hospitalized in Belgian hospitals do not have major complaints about the care they received. Nevertheless concerning
several issues the quality of care could be improved. Moreover, it may be that the quality of
care in hospitals that did not distribute questionnaires may be inferior compared with those
who did.
K. DEPRAETERE, Nationalestraat I155, B - 2000 Antwerp, Belgium Tel. + 32 3-247.64.26, Fax
+ 32-3-247.64.32, E-mail [email protected]
Tu.B.2136
UTILISATION AND EVALUATION OF SERVICES BY PERSONS WITH HIV INFECTION
IN BELGIUM
Colebunders, Robert*, Poortmans E*, James T*, Depraetere K*, De Roo A*. *Institute of
Tropical Medicine, Antwerp, Belgium; **De Witte Raven, Antwerp, Belgium.
Objective:To study the utilisation and evaluation of services by persons with HIV infection
in Belgium.
Methods: An anonymous questionnaire survey was organized among persons known to be
HIV seropositive for at least 3 months. Questionnaires were distributed by general practitioners, HIV treatment centers, other hospitals and support organisations.Three hundred
and thirteen persons with HIV infection participated in the survey Questions were asked
about the frequency of utilisation of health care/support services during the last 6 months.
Services were evaluated by a score I (very bad) - 5 (very good).

Results: As of December 95, a total of 423 physicians have registered in the network.These
registrants have ever provided care to 44,738 HIV positive individuals, of which 89% were
adult men, 9% adult women, and 2% infants and children. General practitioners (GPs), comprising 44% of registrants, cared for 29% of all patients. While duplication may occur
between GPs and specialists, the rate of patient duplication among GPs is I kely to be substantially reduced. In terms of patient populations, the majority of physicians had ever cared
for gay and bisexual men (89%), heterosexual men (7 I%), women (72%), and injection drug
users (70%). However, only a minority had experienced caring for children < 5 years (9%),
children and teens aged 5 - 17 (17%), and infected families (3 I%). In terms of therapeutic
management, 80% of participants provided vaccinations, 87% antiretroviral therapy 92%
provided prophylaxis for opportunistic infections and 86% treated these inlections. New
HIV-positive patients are being accepted by 80% of registered physic ians.
Conclusion: This preliminary analysis suggests Canadian HIV/AIDS care giving physicians are
supportive of a national physician network. Registered physicians are involved in many
aspects of patient care, provide care to a wide segment of the HIV-positive population and
are eager for further education and participation.
Dr Robert Hogg, 608-1081 Burrard Street,Vancouve BC,V6Z I Y6, Canada Telephone:
604-631-551 6 Fax: [phone]
Tu.B.2138
CHANGES IN HOSPITAL RESOURCES UTILIZATION BY HIV PATIENTS- A LOCAL
PERSPECTIVE
Hyland, Meaghen I, Bailey G, Chan CK. University of Toronto,Toronto, ON, Canada
Objective: To examine the characteristics of HIV discharges over a five year period, at a
community based, university affiliated hospital in Toronto, Canada.
Methods: A retrospective study was conducted examining the period between 04/90 and
03/95 at the Wellesley Hospital (WH).
Results: The results are summarized in the table below
Total HIV total WH HIV Avg Overall WH HIV %HIV HIV
Year discharges (cases) discharges RIW Avg RIW Al OS Deaths Discharge/pt
04/90-03/91 102 84 3 765 N/A 1.676 7. 2.21
04/9 -03/92 173 125 13 99;.044 1.725 14.4 6 1.38
04/92-031/93 184 135 13 362 2.5 6 1.32 12.0 16.36
04193 03/94 287 202 12 943.652 1.878 12. 20.43
04/94 03/95 323 266 12 874 2.536 1./ /! 16 43
RIW=resource intensity weight; ALOS=average length of stay;WH Wellesley Hospital
An increase in the total number of discharges from 102 to 323 and a small increase in the
number of discharges/pt was observed over the five years suggesting more readmissions.
The average length of stay (ALOS) decreased significantly frorm 17 diays to 13 days while
the mortality increased only slightlyThe HIV-related Avg RIW has decreased suggesting a
slight reduction in severity/complexity of illness but it remains substantially greater than the
overall Avg RIW for all hospitalizations.
Conclusions: In summary HIV-related hospitalizations in Canada, in the 1990's, have
become less lengthy However, mortality remains high and the caseloads still require much
more resources compared with the average hospital admission.
M.J. Hyland, 200 Elizabeth St, IOEN-220,Toronto, Ontario, M15G 2C4 Canada Telephone:
[phone] email: [email protected]
Tu.B.2139
CHANGES IN HOSPITAL RESOURCES UTILIZATION BY HIV PATIENTS-AN
ONTARIO PERSPECTIVE
Chan, Charles K, Bailey G, Hyland Mj. University ofToronto,Toronto, Canada
Objective: To examine the characteristics of HIV discharges over a five year period, among
peer hospitals in Ontario, Canada.
Methods: A retrospective study was conducted examining the period between 04/90 and
03/95 among 10 of the I I peer hospitals (Kingston General, Sunnybrook, St. Michael' s,
Toronto General/Toronto Western, Wellesley, University Victoria, Ottawa Civic, Hamilton
General, Hamilton Civic Hospitals).
Results:
Total HIV Total Hosp V Avg O verall HIV % HIV
Year discharges discharges RIW Avg RIW ALOS Deaths
04/900/9 884 95 268 3.102 1.719 NA NA
04/91-03/92 I t 17 209 819 3.06,0 1.779 1.5 I7
04/9203/93 12 2 212 851 2.827 1.81. I 7
04/93 03/94 I 33 205 859 2.814 1.874 18 7
04i94-01/95 I 25 206 19I 2.699 1414 in 4
RiW resource intensity weight; ALOS- average length of ra
A 2 1% increase in the total number of HIV related charges fom 884 to I 125 compared to
a 5% increase in total hospital discharges from 195,268 to 206,191 was observed over the
five years.The greater increase in HIV related discharges suggests an increase in the number
of admissions per HIV patient and/or an increase in HIV cases in ntarso.The oHV related
ALOS decreased from 1 1.5 days to tO days.Thae CIV-related Avg RIW has also decrersed
suggesting a slight reduction in severity/complexity of illness but it still remains greater than
the overall Avg RIW for all hospitalizations which has increased slightly during the same
perod.The percentage of HIV deaths remains high. but decreased S-oa 17% to 14%.
Conclusions: In summary HIV-related hospitalizations in Ontario, in tae 1990' s, have
become less lengthy However, mortality r-emains high, the number of admissions have
increased and the caseloads require much more resources coipared with the average hos
pital admissnn
C.K. Chan, 200 Elizabeth St. I 0EN-220,Toronto, Ont. M5G 2C4 Telephone: (4 I 6) 340 3235
Fax: [phone]

Results:

Utilisation of services Evaluper month ation

tiisation of ser- ices Evaluper month ation

0
0)
N
c
O
0)
+0)
a_
r
C
0
CO
C
x_
0)
t
As SNA AIDS score A- NA AIDS score
GeneaPractitioner 1,99 272 315 408 Psychologist 0 0,76 0,81 388
Physi-cian in HIV 2,22 1,46 3,95 4,31 Psychiatrist 0.7 0,52 0,44 2.55
treatmentcenter sexologist 0 0,08 0,21 2,05
Dentist 0,79 1,16 0,76 4,03 Dietician 0,04 0.28 0.6 2.46
Social nurse/worker 0,58 I, 16 1.56 3,97 Buddy system 0.03,n,6 1.31 2,54
Physiotherapist 0,49 0,64 172 3,00 Peer supportgroup 0,41 0,70 0,63 333
As.: Asymptomatic (n= 127), SNA minor symptoms non aids (n= 124).AIDS persons with AIDS (n 48).
Conclusion: In Belgium persons with HIV infection most often use the services of physicians, much less the services of other health care/support providers.
R. COLEBUNDERS, Nationalestraat 155, B - 2000 Antwerp, Belgium, Tel + 32 3 247.64.26,
Fax + 32-3-247.64.32, E-mail [email protected]
Tu.B.2137
CANADA-WIDE PARTICIPATION IN A NETWORK OF HIV/AIDS CARE GIVING
PHYSICIANS
Woodfall, Brian, Hogg RS, Heath KV, Bally G,Yip B, Perry T O'Shaughnessy MV B.C. Centre
for Excellence in HIV/AIDS,Vancouver, Canada; and AIDS Care,Treatment, and Support
Unit, Health Canada, Ottawa, Canada;.
Objective: To characterize the practice profiles of physicians who have enrolled in the
Canadian HIV/AIDS care-giving physician (CHAP) network.
Methods: The CHAP network was created, under a joint venture of Health Carnada and the
BC Centre for Excellence in HIV/AIDS, to establish a national database of physicians experienced in providing care to HIV-positive patients.The main aims of this project were to create a national physician directory and to better focus the development and distribution of
clinical and educational resources to physicians. A registration package inviting participation
in the network was mailed to every physician in Canada known to have cared for patients
with HIV disease. Information on demographic characteristics, number and profile of HIVpositive patients seen, and the services provided to these patients was obtained.

288