Is Outpatient Care Associated with Lower Use of Inpatient and Emergency Care? An Analysis of Persons with HIV Disease

OBJECTIVES: The authors use data from the AIDS Costs and Service Utilization Survey (ACSUS) to investigate the extent to which use of ambulatory medical care is associated with inpatient and emergency department use among HIV-infected persons. METHODS: Parameter estimates were derived from simultaneous, multiequation models. RESULTS: Higher use of ambulatory medical services is not significantly associated with lower probability of inpatient admissions or emergency department (ED) visits. For the subgroup of patients who received an AIDS diagnosis during the study period, however, the number of ambulatory visits had significant negative effects on hospitalizations and ED use. CONCLUSIONS: Outpatient care may offset inpatient and ED services at particular points in the disease course.