The authors studied 217 patients interviewed while hospitalized at seven Southern California hospitals for CD4 counts and illness severity. About one-half of patients reported that medical services were readily accessible. Medical records revealed that since the onset of HIV infection, 49% had two or more total hospitalizations. In multiple regression analysis, better reported access to services was significantly associated with not having been hospitalized (vs. having been hospitalized) over the same time period, controlling for many measures of illness, insurance, and other characteristics. Improving access to community-based medical services for ambulatory HIV-infected patients may help avert costly hospital care, but prospective studies are needed to verify this.
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