Impact of the TV media in HIV Health Care Use:

OBJECTIVE: To investigate health care service and HAART utilization among diverse HIV infected individuals with full access to health care.

METHODS: The number of ambulatory care and emergency room visits, hospital stays, and HAART use were examined among 530 HIV positive patients, consecutively admitted to Univ. Miami/Jackson Memorial Hospital (UM/JMH). Health care utilization by race/ethnicity was examined using qualitative and quantitative methodology.

RESULTS: Despite open health care access at UM/JMH, our data demonstrated striking differences in health care utilization among racial/ethnic groups. Evaluation of outpatient visits indicated that Hispanic patients (47.7±6) and Caribbeans (59±6 visits) were more likely to be seen in the outpatient clinic during the length of the study than African Americans (45.1±3, p=0.04) and Whites (25.2±6, p=0.006). African Americans, on the other hand, had a significantly higher rate of visits to the emergency room (ER), (19.1±18), compared to Hispanics (8.9±7.7 p=0.001), Caribbeans (8.5±6.4, H: 6.4±0.7, p=0.0001), or Caucasians (12.9±15, p=0.02). Moreover, most of the emergency room visits (78%) of the African American and Caucasians, occurred during the day when the HIV outpatient clinic was open and walk-in services could be obtained. Hispanics' visits to the emergency room occurred primarily at night. Qualitative interviews suggest that cultural factors and ER TV programs may have driven those decisions.

CONCLUSIONS: Although the observed differences in health care use are in accord with various national studies, our data is the first that shows that the TV media may influence how individuals use the health system.