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Quality-of-Care Indicators for HIV/AIDS

 

作者: Albert W. Wu,   Allen Gifford,   Steven Asch,   Susan E. Cohn,   Samuel A. Bozzette,   Robin Yurk,  

 

期刊: Disease Management & Health Outcomes  (ADIS Available online 2000)
卷期: Volume 7, issue 6  

页码: 315-330

 

ISSN:1173-8790

 

年代: 2000

 

出版商: ADIS

 

关键词: Acquired immunodeficiency syndrome, prevention;Acquired immunodeficiency syndrome, treatment;Antivirals, therapeutic use;HIV infections, prevention;HIV infections, treatment;Immunocompromised infections, diagnosis;Immunocompromised infections, prevention;

 

数据来源: ADIS

 

摘要:

As care for HIV/AIDS becomes more concentrated within specific providers and organisations, it would be useful to have indicators to describe the quality of care. This paper reviews concepts related to quality of care, and practical issues including sampling and risk adjustment. Indicators can be collected using a combination of administrative, chart review and survey data to reflect clinical, patient and societal perspectives. We suggest that for adults with HIV/AIDS, indicators might include measures of health status and patient satisfaction, and essential care processes. Health status measures could include CD4+ T-lymphocyte count and HIV-RNA, progression to AIDS, symptom scores, health-related quality of life scores, patient utility and disability days. Essential care processes could include receipt of acceptable antiretroviral treatment, CD4+ and HIV-RNA monitoring, screening for opportunistic infections, prophylaxis againstPneumocystis cariniipneumonia, handling of symptoms and pneumococcal vaccination. For those at increased risk for HIV, potential indicators include screening for HIV risk behaviours and HIV testing. Data from indicators such as these could be used by individuals to select among providers, purchasers of care to select among health plans and payors to hold provider groups accountable. In addition, data could be used by groups of providers to improve the quality of care.

 

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