scholarly journals Emergency Department Patient Acceptance of Opt-in, Universal, Rapid HIV Screening

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 27-40 ◽  
Author(s):  
Roland C. Merchant ◽  
George R. Seage ◽  
Kenneth H. Mayer ◽  
Melissa A. Clark ◽  
Victor G. DeGruttola ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Health Insurance ◽  
Regression Model ◽  
Hiv Testing ◽  
Regression Models ◽  
Private Health Insurance ◽  
Demographic Characteristics ◽  
Patient Acceptance ◽  
Hiv Screening

Objectives. We assessed emergency department (ED) patient acceptance of opt-in, rapid human immunodeficiency virus (HIV) screening and identified demographic characteristics and HIV testing-history factors associated with acceptance of screening. Methods. A random sample of 18- to 55-year-old ED patients was offered rapid HIV screening. Patient acceptance or decline of screening and the reasons for acceptance or decline were analyzed with multivariable regression models. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for the logistic regression models. Results. Of the 2,099 participants, 39.3% accepted HIV screening. In a multinomial regression model, participants who were never married/not partnered, did not have private health insurance, and had 12 or fewer years of education were more likely to be screened due to concern about a possible HIV exposure. In a multivariable logistic regression model, the odds of accepting screening were greater among those who were younger than 40 years old (OR=1.61, 95% CI 1.32, 2.00), nonwhite (OR=1.28, 95% CI 1.04, 1.58), not married (OR=1.82, 95% CI 1.44, 2.28), lacking private health insurance (OR=1.40, 95% CI 1.13, 1.74), and who had 12 or fewer years of education (OR=1.43, 95% CI 1.16, 1.75). Despite use of a standardized protocol, patient acceptance of screening varied by which research assistant asked them to be screened. Patients not previously tested for HIV who were white, married, and 45 years or older and who had private health insurance were more likely to decline HIV screening. Conclusions. In an opt-in, universal, ED HIV screening program, patient acceptance of screening varied by demography, which indicates that the impact of such screening programs will not be universal. Future research will need to determine methods of increasing uptake of ED HIV screening that transcend patient demographic characteristics, HIV testing history, and motivation for testing.

scholarly journals Patient Perceptions and Acceptance of Routine Emergency Department HIV Testing

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 21-26 ◽  
Author(s):  
Jeremy Brown ◽  
Irene Kuo ◽  
Jennifer Bellows ◽  
Ryan Barry ◽  
Peter Bui ◽  
...  
Keyword(s):  
Emergency Department ◽  
African American ◽  
Hiv Testing ◽  
Acceptance Rate ◽  
Patient Acceptance ◽  
Hiv Screening ◽  
Asian Patients ◽  
Academic Center ◽  
Hiv Test ◽  
High Prevalence

Objectives. We report on the rates of patient acceptance and their perceptions of routine emergency department (ED) human immunodeficiency virus (HIV) testing in a high-prevalence area. Methods. We analyzed the race/ethnicity of patients who either accepted or declined a routine HIV test that was offered to all patients in the ED of a large academic center. We also distributed a patient perception survey about ED HIV testing. Results. During the study period, an HIV screening test was offered to 9,826 patients. Of these, 5,232 patients (53%) accepted the test. The acceptance rate of HIV testing was highest among African American patients (55%), followed by 52% for white, 50% for Hispanic, and 42% for Asian patients. A total of 1,519 completed surveys were returned for analysis. The most common reasons for declining a test were that patients did not perceive themselves to be at risk for HIV (49%) or they had recently been tested for HIV (18%). Overall, 84% of patients stated they would recommend to a friend to get an HIV test in the ED. When analyzed by ethnicity, 89% of African American patients stated they would recommend to a friend to get an HIV test if the friend went to the ED, but only 74% of white patients would do so. Conclusions. The Centers for Disease Control and Prevention's 2006 recommendations on HIV screening are well accepted by the target populations. Further work at explaining the risk of HIV infection to ED patients should be undertaken and may boost the acceptance rate of ED HIV screening.

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

scholarly journals 1120. Impact of Training Residents to Improve HIV Screening in a Teaching Hospital in Mexico City

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S590-S590
Author(s):  
Lorena Guerrero-Torres ◽  
Isaac Núñez-Saavedra ◽  
Yanink Caro-Vega ◽  
Brenda Crabtree-Ramírez
Keyword(s):  
Emergency Department ◽  
Time Series ◽  
Hiv Testing ◽  
Teaching Hospital ◽  
Educational Intervention ◽  
Temporal Trends ◽  
Hiv Screening ◽  
Hiv Diagnosis ◽  
Post Intervention ◽  
Hiv Test

Abstract Background Among 230,000 people living with HIV in Mexico, 24% are unaware of their diagnosis, and half of newly diagnosed individuals are diagnosed with advanced disease. Early diagnosis is the goal to mitigate HIV epidemic. Missed opportunities may reflect a lack of clinicians’ consideration of HIV screening as part of routine medical care. We assessed whether an educational intervention on residents was effective to 1) improve the knowledge on HIV screening; 2) increase the rate of HIV tests requested in the hospitalization floor (HF) and the emergency department (ED); and 3) increase HIV diagnosis in HF and ED. Methods Internal Medicine and Surgery residents at a teaching hospital were invited to participate. The intervention occurred in August 2018 and consisted in 2 sessions on HIV screening with an expert. A questionnaire was applied before (BQ) and after (AQ) the intervention, which included HIV screening indications and clinical cases. The Institutional Review Board approved this study. Written informed consent was obtained from all participants. BQ and AQ scores were compared with a paired t-test. To evaluate the effect on HIV test rate in the HF and ED, an interrupted time series analysis was performed. Daily rates of tests were obtained from September 2016 to August 2019 and plotted along time. Restricted cubic splines (RCS) were used to model temporal trends. HIV diagnosis in HF and ED pre- and post-intervention were compared with a Fisher’s exact test. A p< 0.05 was considered significant. Results Among 104 residents, 57 participated and completed both questionnaires. BQ score was 79/100 (SD±12) and AQ was 85/100 (SD±8), p< .004. Time series of HIV testing had apparent temporal trends (Fig 1). HIV test rate in the HF increased (7.3 vs 11.1 per 100 episodes) and decreased in the ED (2.6 vs 2.3 per 100 episodes). HIV diagnosis increased in the HF, from 0/1079 (0%) pre-intervention to 5/894 (0.6%) post-intervention (p< .018) (Table 1). Fig 1. HIV test rates. Gray area represents post-intervention period. Table 1. Description of episodes, HIV tests and rates pre- and post-intervention in the Emergency Department and Hospitalization Floor. Conclusion A feasible educational intervention improved residents’ knowledge on HIV screening, achieved maintenance of a constant rate of HIV testing in the HF and increased the number of HIV diagnosis in the HF. However, these results were not observed in the ED, where administrative barriers and work overload could hinder HIV screening. Disclosures All Authors: No reported disclosures

Routine HIV Screening in Cancer Patients in the Emergency Department

2018 ◽  
Vol 17 (2) ◽  
pp. 91-95
Author(s):  
Terry W Rice ◽  
◽  
Patricia A. Brock ◽  
Carmen Gonzalez ◽  
Kelly W Merriman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Cancer Patients ◽  
Linkage To Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
Routine Hiv Screening ◽  
Incident Cases

Treatment of human immunodeficiency virus(HIV) in cancer patients improves outcomes and reduces transmission of this oncogenic virus. HIV testing rates of cancer patients are similar to the general population (15-40%), despite the association with cancer. Our aim was to increase HIV screening in the Emergency Department(ED) of a comprehensive cancer center through a quality initiative. Testing increased significantly during the intervention (p<0.001; 0.15/day to 2.69/day). Seropositive HIV rate was 1.4% (12/852), with incidence of 0.3%. All patients were linked to care. Incident cases were between 36 and 55 years of age. Barriers encountered included confusion regarding the need for written consent for HIV testing, failure to consider ordering the test, and concerns regarding linkage to care.

scholarly journals Analysis models for variables associated with breastfeeding duration

2013 ◽  
Vol 31 (3) ◽  
pp. 306-314 ◽  
Author(s):  
Edson Theodoro dos S. Neto ◽  
Eliana Zandonade ◽  
Adauto Oliveira Emmerich
Keyword(s):  
Logistic Regression ◽  
Protective Factors ◽  
Regression Model ◽  
Odds Ratio ◽  
Regression Models ◽  
Adjusted Odds Ratio ◽  
Cox Regression ◽  
Bottle Feeding ◽  
Breastfeeding Duration ◽  
Factors Associated

OBJECTIVE To analyze the factors associated with breastfeeding duration by two statistical models. METHODS A population-based cohort study was conducted with 86 mothers and newborns from two areas primary covered by the National Health System, with high rates of infant mortality in Vitória, Espírito Santo, Brazil. During 30 months, 67 (78%) children and mothers were visited seven times at home by trained interviewers, who filled out survey forms. Data on food and sucking habits, socioeconomic and maternal characteristics were collected. Variables were analyzed by Cox regression models, considering duration of breastfeeding as the dependent variable, and logistic regression (dependent variables, was the presence of a breastfeeding child in different post-natal ages). RESULTS In the logistic regression model, the pacifier sucking (adjusted Odds Ratio: 3.4; 95%CI 1.2-9.55) and bottle feeding (adjusted Odds Ratio: 4.4; 95%CI 1.6-12.1) increased the chance of weaning a child before one year of age. Variables associated to breastfeeding duration in the Cox regression model were: pacifier sucking (adjusted Hazard Ratio 2.0; 95%CI 1.2-3.3) and bottle feeding (adjusted Hazard Ratio 2.0; 95%CI 1.2-3.5). However, protective factors (maternal age and family income) differed between both models. CONCLUSIONS Risk and protective factors associated with cessation of breastfeeding may be analyzed by different models of statistical regression. Cox Regression Models are adequate to analyze such factors in longitudinal studies.

scholarly journals Demographic Variations in HIV Testing History among Emergency Department Patients: Implications for Hiv Screening in US Emergency Departments

2009 ◽  
Vol 16 (2) ◽  
pp. 60-66 ◽  
Author(s):  
Roland C Merchant ◽  
Bethany M Catanzaro ◽  
George R Seage ◽  
Kenneth H Mayer ◽  
Melissa A Clark ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Emergency Departments ◽  
Hiv Screening ◽  
Emergency Department Patients

scholarly journals Aplicación de modelos de regresión logística en metodología observacional: modalidades de competición en la iniciación al fútbol.

2015 ◽  
Vol 32 (1) ◽  
pp. 288 ◽  
Author(s):  
Daniel Lapresa ◽  
Javier Arana ◽  
M.Teresa Anguera ◽  
J.Ignacio Pérez-Castellanos ◽  
Mario Amatria
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Regression Model ◽  
Regression Models ◽  
Logistic Regression Model ◽  
Multiple Logistic Regression ◽  
Observational Methodology ◽  
Logistic Regression Models ◽  
Game Format ◽  
Simple Logistic

This study shows how simple and multiple logistic regression can be used in observational methodology and more specifically, in the fields of physical activity and sport. We demonstrate this in a study designed to determine whether three-a-side futsal or five-a-side futsal is more suited to the needs and potential of children aged 6-to-8 years. We constructed a multiple logistic regression model to analyze use of space (depth of play) and three simple logistic regression models to determine which game format is more likely to potentiate effective technical and tactical performance.

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