Structures of care in the clinics of the HIV Research Network

As the HIV epidemic has evolved to become a chronic, treatable condition the focus of HIV care has shifted from the inpatient to the outpatient arena. The optimal structure of HIV care in the outpatient setting is unknown. Using the HIV Research Network (HIVRN), a federally sponsored consortium of 2...

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Veröffentlicht in:AIDS patient care and STDs 2008-12, Vol.22 (12), p.1007-1013
Hauptverfasser: Yehia, Baligh R, Gebo, Kelly A, Hicks, Perrin B, Korthuis, P Todd, Moore, Richard D, Ridore, Michelande, Mathews, William Christopher
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container_end_page 1013
container_issue 12
container_start_page 1007
container_title AIDS patient care and STDs
container_volume 22
creator Yehia, Baligh R
Gebo, Kelly A
Hicks, Perrin B
Korthuis, P Todd
Moore, Richard D
Ridore, Michelande
Mathews, William Christopher
description As the HIV epidemic has evolved to become a chronic, treatable condition the focus of HIV care has shifted from the inpatient to the outpatient arena. The optimal structure of HIV care in the outpatient setting is unknown. Using the HIV Research Network (HIVRN), a federally sponsored consortium of 21 sites that provide care to HIV-infected individuals, this study attempted to: (1) document key features of the organization of care in HIVRN adult clinics and (2) estimate variability among clinics in these parameters. A cross-sectional survey of adult clinic directors regarding patient volume, follow-up care, provider characteristics, acute patient care issues, wait times, patient safety procedures, and prophylaxis practices was conducted from July to December 2007. All 15 adult HIVRN clinic sites responded: 9 academic and 6 community-based. The results demonstrate variability in key practice parameters. Median (range) of selected practice characteristics were: (1) annual patient panel size, 1300 (355-5600); (2) appointment no-show rate, 28% (8%-40%); (3) annual loss to follow-up, 15% (5%-25%); (4) wait time for new appointments, 5 days (0.5-22.5), and follow-up appointment, 8 days (0-30). The majority of clinics had an internal mechanism to handle acute patient care issues and provide a number of onsite consultative services. Nurse practitioners and physician assistants were highly utilized. These data will facilitate improvements in chronic care management of persons living with HIV.
doi_str_mv 10.1089/apc.2008.0093
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The optimal structure of HIV care in the outpatient setting is unknown. Using the HIV Research Network (HIVRN), a federally sponsored consortium of 21 sites that provide care to HIV-infected individuals, this study attempted to: (1) document key features of the organization of care in HIVRN adult clinics and (2) estimate variability among clinics in these parameters. A cross-sectional survey of adult clinic directors regarding patient volume, follow-up care, provider characteristics, acute patient care issues, wait times, patient safety procedures, and prophylaxis practices was conducted from July to December 2007. All 15 adult HIVRN clinic sites responded: 9 academic and 6 community-based. The results demonstrate variability in key practice parameters. Median (range) of selected practice characteristics were: (1) annual patient panel size, 1300 (355-5600); (2) appointment no-show rate, 28% (8%-40%); (3) annual loss to follow-up, 15% (5%-25%); (4) wait time for new appointments, 5 days (0.5-22.5), and follow-up appointment, 8 days (0-30). The majority of clinics had an internal mechanism to handle acute patient care issues and provide a number of onsite consultative services. Nurse practitioners and physician assistants were highly utilized. 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subjects Adolescent
Adult
AIDS/HIV
Ambulatory Care Facilities - classification
Ambulatory Care Facilities - manpower
Ambulatory Care Facilities - organization & administration
Antiretroviral Therapy, Highly Active
Appointments and Schedules
Community Health Centers - organization & administration
Continuity of Patient Care
Cross-Sectional Studies
Disease management
Epidemics
Female
Health Care Surveys
Health services utilization
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - prevention & control
Human immunodeficiency virus
Humans
Inpatient care
Insurance, Health
Male
Middle Aged
Studies
Surveys and Questionnaires
Urban Population
Waiting Lists
Young Adult
title Structures of care in the clinics of the HIV Research Network
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