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 |
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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. These data will facilitate improvements in chronic care management of persons living with HIV.</description><identifier>ISSN: 1087-2914</identifier><identifier>EISSN: 1557-7449</identifier><identifier>DOI: 10.1089/apc.2008.0093</identifier><identifier>PMID: 19072107</identifier><identifier>CODEN: APACEF</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>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</subject><ispartof>AIDS patient care and STDs, 2008-12, Vol.22 (12), p.1007-1013</ispartof><rights>Copyright Mary Ann Liebert Inc. 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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. These data will facilitate improvements in chronic care management of persons living with HIV.</description><subject>Adolescent</subject><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Ambulatory Care Facilities - classification</subject><subject>Ambulatory Care Facilities - manpower</subject><subject>Ambulatory Care Facilities - organization & administration</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Appointments and Schedules</subject><subject>Community Health Centers - organization & administration</subject><subject>Continuity of Patient Care</subject><subject>Cross-Sectional Studies</subject><subject>Disease management</subject><subject>Epidemics</subject><subject>Female</subject><subject>Health Care Surveys</subject><subject>Health services utilization</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Insurance, Health</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Urban Population</subject><subject>Waiting Lists</subject><subject>Young Adult</subject><issn>1087-2914</issn><issn>1557-7449</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUlPwzAQRi0EolA4ckURB24pYyfxcgAJVUArIZDYrpbr2jSQxsVOQPx7HFqxXTh5e3ozng-hPQwDDFwcqYUeEAA-ABDZGtrCRcFSludiPe6Bs5QInPfQdghPEDFSwCbqYQGMYGBb6Pi28a1uWm9C4myilTdJWSfNzCS6KutSf153x9H4IbkxwSivZ8mVad6cf95BG1ZVweyu1j66Pz-7G47Sy-uL8fD0MtV5njWpyq1imk54QTOusRVA8gJySoAQzgpuLGVTYznJQFPFjGCETzLKsMoss5hnfXSy9C7aydxMtakbryq58OVc-XfpVCl_v9TlTD66V0koxJosCg5XAu9eWhMaOS-DNlWlauPaIKngTAj2PxhHHYW0a-ngD_jkWl_HKUhCaLQBoRFKl5D2LgRv7FfLGGQXn4zxdU4uu_giv__zn9_0Kq_sAzjXlBA</recordid><startdate>200812</startdate><enddate>200812</enddate><creator>Yehia, Baligh R</creator><creator>Gebo, Kelly A</creator><creator>Hicks, Perrin B</creator><creator>Korthuis, P Todd</creator><creator>Moore, Richard D</creator><creator>Ridore, Michelande</creator><creator>Mathews, William Christopher</creator><general>Mary Ann Liebert, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T5</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7U2</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200812</creationdate><title>Structures of care in the clinics of the HIV Research Network</title><author>Yehia, Baligh R ; 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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. These data will facilitate improvements in chronic care management of persons living with HIV.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>19072107</pmid><doi>10.1089/apc.2008.0093</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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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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