The learning curve for AIDS-related Pneumocystis carinii pneumonia: experience from 3,981 cases in Veterans Affairs hospitals 1987-1991

Article Abstract:

AIDS patients experiencing their first episode of Pneumocystis carinii pneumonia (PCP) appear to live longer if they are treated at hospitals that have more experience caring for AIDS patients. The mortality rate of AIDS patients with PCP seen between October 1986 and September 1991 at 140 Veterans Administration hospitals was evaluated. A total of 3,981 patients experiencing their first episode of PCP were identified. Of the hospitals, 107 treated fewer than four patients experiencing their first episode of PCP in 1991. A total of 437 patients were treated at these low volume hospitals. In comparison, 382 patients experiencing their first episode of PCP were treated at a VA hospital that cared for more than 50 similar patients in 1992. The overall mortality rate at 30 days after hospital admission was 19%. Patients treated at high volume hospitals were significantly less likely to die than patients treated a low volume hospitals. Decreases in death rates from 23.6% in 1987 to 16.1% in 1991 suggest that as hospitals care for more of these patients mortality rates decrease.

Health aspects, Hospitals, Veterans', Veterans hospitals

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Differences between men and women with HIV-related Pneumocystis carinii pneumonia: experience from 3,070 cases in New York City in 1987

Article Abstract:

Differences in demographic factors and medical treatment in patients suffering from their first episode of Pneumocystis carinii pneumonia (PCP) may lead to a higher mortality rate for women. A review of the medical records of 70 hospitals in New York City found significant demographic differences between women and men hospitalized with PCP. Women were most often younger and more likely to be non-white. They were also less likely to have health insurance than men. Women were also more likely to receive care at a hospital with less experience treating patients with AIDS or PCP. Review of treatment procedures indicated that women may have received less aggressive treatment than men and that practitioners who were not experienced in treating AIDS may have been less likely to consider a diagnosis of AIDS or PCP in a female patient. No data indicated that women responded less well to treatment than men.

Women, Demographic aspects, AIDS (Disease), AIDS (Disease) in women

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Predictors of resource utilization for hospitalized patients with Pneumocystis carinii pneumonia (PCP): a summary of effects from the multi-city study of quality of PCP care

Article Abstract:

There appear to be significant variations in the treatment of Pneumocystis carinii pneumonia (PCP) depending on the characteristics of the patient and the hospital. A review of 2,174 patients with PCP at 96 hospitals in five cities between 1987 and 1990 revealed that certain groups were less likely to receive bronchoscopies and medication for PCP within the first two days of admission. They included women, those who acquired HIV via blood transfusion and intravenous drug users. People on Medicaid and those treated at VA hospitals were also less likely to be treated promptly.

HIV patients

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