Health Issues is a general health based blog concentrating on multiple health topics.

Most people with HIV infection are admitted to a hospital at some time during the course of the infection; most will be hospitalized two to four times, spending an average of thirty to sixty days, total, in the hospital. They may or may not have a choice of what hospitals they are admitted to. As discussed in a later section, the choice is largely dictated by the type of insurance they have and the hospitals to which their physicians have admitting privileges. People are often frightened about going to a hospital—to be sure, hospitals are confusing places. This section discusses hospitals, and their people and practices, in an attempt to lessen the fear and confusion.

Teaching and Community Hospitals-Hospitals differ in the services provided and the style of care. One of the biggest differences is between teaching hospitals and community hospitals. Teaching hospitals are generally larger hospitals that provide on-the-job training for medical residents and often for medical students as well. Teaching hospitals are often affiliated with medical schools, the physicians are often on the medical school faculty, and physicians may be responsible both for patient care and for research programs.

The advantage of teaching hospitals is that their resources for testing and treatment are both extensive and up to date. This is important in a field that changes as rapidly as research in the treatment of HIV infection. Teaching hospitals are also more likely to have comprehensive

programs for the care of people with HIV infection. A survey of physicians by U.S. News and World Report in 1990 showed that all the top-ranked hospitals for the care of AIDS were teaching hospitals. In order of rank, they were: San Francisco General Hospital, the Johns   Hopkins Hospital in Baltimore, Massachusetts General Hospital in Boston, St. Vincent’s Hospital in New York City, Memorial Sloan-Kettering Cancer Center in New York City, the University of Washington Medical Center in Seattle, Duke University in Durham, North Carolina, and the Mayo Clinic in Rochester, Minnesota. This list is of particular interest because it was made up by physicians; these are the hospitals the physicians themselves would choose for AIDS care.

Community hospitals tend to be smaller hospitals with fewer resources and whose staff physicians often have less experience with HIV infection. Nevertheless, many community hospitals have devoted physicians who provide excellent care in an environment less overwhelming than that of a large teaching hospital.

Experience counts, however. Surveys of hospitals caring for people with HIV show that survival is better and the length of stay is shorter in hospitals which treat many people with HIV, compared to hospitals which treat few people with HIV infection. Still, there is no doubt that many of the common complications of HIV infection can be easily managed in a community hospital.

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