Title

Closing the Gaps in Missed Opportunities: Role of the Emergency Department in Implementing Public Health Programs

Document Type

Presentation

Publication Date

11-16-2018

Comments

Presentation: 4:45

Abstract

Emergency Departments (EDs) serve as a safety net. CDC recommends yearly HIV testing for those identified with high risk. As part of the CDC’s Expanded HIV Testing Initiative, EDs were also identified as ideal sites for HIV screening. This study aimed to evaluate the potential missed opportunities prior to patients being newly diagnosed with HIV in an urban ED. This was a retrospective chart review of patients newly diagnosed with HIV through an ED based HIV screening program on two campuses of an urban, academic medical institution. Focus was placed on total number diagnosed, CDC characterized risk factors, and number of visits to ED and/or ambulatory setting prior to being diagnosed. Data analysis was done through descriptive variables. 58 patients were newly diagnosed with HIV during the study period, 79% male, 67% black, and 12% were insured. 79% were diagnosed with chronic HIV. Of these 58 patients, 32 (55%) presented with at least one CDC characterized risk factor. 42 (72%) had previously presented to the health system in the five years prior to diagnosis; of these, there were 131 ambulatory visits and 65 ED visits. The average number of outpatient visits were 6.24 visits per 21 patients, representing potential missed opportunities for earlier diagnoses in primary care. While EDs serve a population with higher risk and lower access to care, this study highlights missed opportunities in the outpatient setting when CDC recommendations were not followed. EDs are ideal sites for public heath interventions, such as HIV screening.

Language

English

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