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首页> 外文期刊>AIDS care. >Association of ancillary services with primary care utilization and retention for patients with HIV/AIDS.
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Association of ancillary services with primary care utilization and retention for patients with HIV/AIDS.

机译：艾滋病毒/艾滋病患者的辅助服务与初级保健的利用和保留之间的联系。

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Fenway Community Health Center (FCHC), located in Boston, Massachusetts, provides comprehensive care to persons with HIV/AIDS, including medical, mental health and other health-related services. In this paper, we present results from an analysis of existing data about the demographic and clinical characteristics, service needs and utilization patterns, and primary care retention of HIV-positive primary care patients seen at FCHC during a 24-month study period. Patient data were extracted from Logician, FCHC's electronic medical record system, and imported into Microsoft Access, Microsoft Excel and SAS for manipulation and analysis. A total of 999 unique individuals were included in the study population. Most were men (97%), white (75%) and between 39 and 80 years of age. Patients averaged 6.7 medical visits annually at FCHC, and 61% had at least one medical visit every six months. Significant predictors of primary care utilization were insurance status, HIV disease stage, being on combination therapy, first CD4 count, first viral load level and receipt of ancillary services. Need and receipt of ancillary services were found through medical and case management record review; case management was the most used ancillary service, received by 36% of the study population. For most ancillary services, clients with assessed need had documented receipt of the service. Publicly insured and/or Ryan White CARE Act-funded patients had the greatest ancillary service utilization. The influence of ancillary services upon primary care entry could not be evaluated with available data; however, their influence upon primary care was significant. For patients who received primary care in every continuous six-month period, statistically significant associations were found with receipt of mental health care, case management, drug assistance, foodutrition, complementary services and housing. Using the more rigorous FCHC standard of care (minimum of four primary care visits per year), significant associations were also found with transportation, legal services and substance abuse treatment. For non-whites and women, mental health care, foodutrition, housing and transportation had particular significance.
机译：位于马萨诸塞州波士顿的芬威社区卫生中心（FCHC）为艾滋病毒/艾滋病患者提供全面护理，包括医疗，心理健康和其他与健康相关的服务。在本文中，我们通过对在24个月研究期间在FCHC上看到的HIV阳性初级保健患者的人口统计学和临床​​特征，服务需求和使用模式以及初级保健保留率的现有数据进行分析，得出结果。患者数据是从FCHC的电子病历系统Logician中提取的，并导入到Microsoft Access，Microsoft Excel和SAS中进行操作和分析。研究人群中总共包括999个独特的个体。大多数是男性（97％），白人（75％）且年龄在39至80岁之间。患者每年在FCHC上平均进行6.7次医疗访问，而61％的患者每六个月至少进行一次医疗访问。初级保健使用的重要预测指标是保险状况，HIV疾病分期，联合治疗，首次CD4计数，首次病毒载量水平和接受辅助服务。通过医疗和病例管理记录审查发现辅助服务的需要和接受;案例管理是最常用的辅助服务，占研究人群的36％。对于大多数辅助服务，已评估需求的客户已记录了该服务的收据。由公共保险和/或Ryan White CARE法案资助的患者具有最大的辅助服务利用率。无法利用现有数据评估辅助服务对初级保健进入的影响;但是，它们对初级保健的影响很大。对于每六个月连续接受一次初级保健的患者，发现在心理保健，病例管理，药物援助，食品/营养，补充服务和住房方面有统计学意义的关联。使用更加严格的FCHC护理标准（每年至少进行四次初级保健就诊），还发现与运输，法律服务和药物滥用治疗之间存在重要关联。对于非白人和妇女而言，精神保健，食物/营养，住房和交通运输具有特别重要的意义。

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