Cost of Care for HIV-Infected Patients with Co-Occurring Substance Use Disorder or Psychiatric Disease: Report from a Large, Integrated Health Plan
Table 2
Log-linear GEE regression: cost of care associated with the joint diagnoses of substance use disorder (SU) and psychiatric disease (PD), adjusted for demographic and clinical characteristics in HIV-infected patients receiving care at the KPNC health plan.
Outcome
Diagnosis
Unadjusted OR (95% C.I.)
Partially adjusted* OR (95% C.I.)
Fully adjusted** OR (95% C.I.)
Model 1
Model 2
Model 3
Total costs
Both PD and SU diagnoses
1.53 (1.46, 1.60)
1.35 (1.29, 1.42)
1.35 (1.29, 1.42)
PD diagnosis only
1.34 (1.29, 1.40)
1.21 (1.16, 1.26)
1.19 (1.15, 1.24)
SU diagnosis only
1.35 (1.28, 1.42)
1.26 (1.20, 1.33)
1.24 (1.18, 1.31)
Neither PD nor SU diagnosis
1.00 (ref)
1.00 (ref)
1.00 (ref)
Inpatient costs
Both PD and SU diagnoses
1.29 (1.11, 1.50)
1.67 (1.42, 1.97)
2.22 (1.85, 2.66)
PD diagnosis only
1.03 (0.88, 1.21)
1.17 (0.98, 1.38)
1.28 (1.11, 1.49)
SU diagnosis only
1.74 (1.49, 2.02)
1.92 (1.63, 2.27)
2.14 (1.78, 2.58)
Neither PD nor SU diagnosis
1.00 (ref)
1.00 (ref)
1.00 (ref)
Outpatient costs
Both PD and SU diagnoses
1.48 (1.36, 1.61)
1.55 (1.43, 1.67)
1.52 (1.41, 1.64)
PD diagnosis only
1.24 (1.16, 1.32)
1.28 (1.20, 1.36)
1.28 (1.20, 1.37)
SU diagnosis only
1.26 (1.17, 1.37)
1.28 (1.19, 1.37)
1.27 (1.17, 1.38)
Neither PD nor SU diagnosis
1.00 (ref)
1.00 (ref)
1.00 (ref)
Pharmacy costs
Both PD and SU diagnoses
2.32 (2.24, 2.40)
1.16 (1.11, 1.21)
1.10 (1.06, 1.14)
PD diagnosis only
1.75 (1.70, 1.81)
1.13 (1.09, 1.17)
1.08 (1.04, 1.10)
SU diagnosis only
1.65 (1.60, 1.71)
1.10 (1.07, 1.14)
1.06 (1.03, 1.09)
Neither PD nor SU diagnosis
1.00 (ref)
1.00 (ref)
1.00 (ref)
Adjusted for age at time when cost occurred, year when costs occurred, sex, and race/ethnicity.
**Adjusted for age, year when costs occurred, sex, race/ethnicity, HIV transmission risk group, HIV RNA level, and CD4+ cell count (both time-dependent).
