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Use of unpaid and paid home care services among people with HIV infection in the USA.

机译：在美国，艾滋病毒感染者使用无偿和有偿家庭护理服务。

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This paper examines utilization of paid and unpaid home health care using data from a nationally representative sample of HIV-positive persons receiving medical care in early 1996 (N = 2,864). Overall, 21.0% used any home care, 12.2% used paid care and 13.6% used unpaid care. Most (70.0%) users of home care received care from only one type of provider. Substantially more hours of unpaid than paid care were used. We also found evidence of a strong association between type of service used and type of care provider: 62.4% of persons who used nursing services only received paid care only; conversely, 55.5% of persons who used personal care services only received care only from unpaid caregivers. Use of home care overall was concentrated among persons with AIDS: 39.5% of persons with AIDS received any home health care, compared to 9.5% of those at earlier disease stages. In addition to having an AIDS diagnosis, logistic regression analyses indicated that other need variables significantly increased utilization; a higher number of HIV-related symptoms, lower physical functioning, less energy, a diagnosis of CMV and a recent hospitalization each independently increased the odds of overall home care utilization. Sociodemographic variables had generally weak relationships with overall home care utilization. Among users of home care, non-need variables had more influence on use of paid than unpaid care. Both paid and unpaid home health care is a key component of community-based systems of care for people with HIV infection. The results presented in this paper are the first nationally representative estimates of home care utilization by persons with HIV/AIDS and are discussed with reference to policy and future research.
机译：本文使用1996年初接受医疗保健的全国有代表性的HIV阳性人群的样本数据检验有偿和无偿家庭医疗的利用（N = 2,864）。总体而言，有21.0％的人使用了任何家庭护理，有12.2％的人使用了付费护理，有13.6％的人使用了无偿护理。大多数（70.0％）的家庭护理用户仅从一种提供者那里获得护理。无偿工作小时数多于有偿服务小时数。我们还发现使用的服务类型与护理提供者的类型之间有很强的联系：62.4％的仅使用护理服务的人仅获得有偿护理;相反，使用个人护理服务的人中有55.5％仅从无偿护理人员那里得到护理。总体而言，家庭护理的使用集中在艾滋病患者中：39.5％的艾滋病患者接受了任何家庭保健，而疾病早期阶段的这一比例为9.5％。 Logistic回归分析表明，除了可以诊断艾滋病外，其他需求变量还可以显着提高利用率。大量与HIV相关的症状，较低的身体机能，较少的精力，对CMV的诊断以及最近的住院治疗均独立增加了整体家庭护理使用的几率。社会人口统计学变量通常与整体家庭护理利用之间的关系较弱。在家庭护理使用者中，非需要变量对有偿使用的影响比无偿护理更大。有偿和无偿家庭保健都是基于社区的艾滋病毒感染者保健系统的关键组成部分。本文介绍的结果是艾滋病毒/艾滋病患者使用家庭护理的第一个全国代表性估计，并结合政策和未来研究进行了讨论。

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