Impact of Patient–Provider Attachment on Hospital Readmissions Among People Living With HIV: A Population-Based Study


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Abstract

Background:Hospital readmission 30 days after discharge is associated with adverse health outcomes, and people living with HIV (PLWH) experience elevated rates of hospital readmission. Although continuity of care with a health care provider is associated with lower rates of 30-day readmission among the general population, little is known about this relationship among PLWH. The objective of this study is to examine whether engaging with the same provider, defined as patient–provider attachment, is associated with 30-day readmission for this population.Setting:Data were derived from the Seek and Treat for Optimal Prevention of HIV in British Columbia cohort.Methods:Using generalized estimating equation with a logit link function, we examined the association between patient–provider attachment and 30-day hospital readmission. We determined whether readmission was due to all cause or to a similar cause as the index admission.Results:Seven thousand thirteen PLWH were hospitalized during the study period. Nine hundred twenty-one (13.1%) were readmitted to hospital for all cause and 564 (8.0%) for the similar cause as the index admission. Patient–provider attachment was negatively associated with 30-day readmission for all causes (adjusted odds ratio = 0.85, confidence interval = 0.83 to 0.86). A second multivariable model indicated that patient–provider attachment was also negatively associated with 30-day readmission for a similar cause (adjusted odds ratio = 0.86, confidence interval = 0.84 to 0.88).Conclusions:Our results indicate that a higher proportion of patient–provider attachment was negatively associated with 30-day hospital readmission among PLWH. Our study findings support the adoption of interventions that seek to build patient–provider relationships to optimize outcomes for PLWH and enhance health care sustainability.

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