3116.0: Monday, November 13, 2000 - Table 4

Abstract #10741

Impact of Ryan White support on health status and social needs of infants and children

Keith Krasinski, MD1, Susan Abramowitz, PhD1, Nessa Obten, CSW2, and Phillip Alcabes3. (1) Pediatrics and Environmental Medicine, New York University School of Medicine, NB 8-West 51, 550 First Avenue, New York, NY 10016, 212/263-8797, keith.krasinski@med.nyu.edu, (2) NYU School of Medicine, NB 8-West 51, 550 First Avenue, New York, NY 10016, (3) Program in Urban Public Health, School of Health Sciences, Hunter College of CUNY, 425 Est 25th Street, New York, NY 10010

Purpose: To investigate the impact of Ryan White Care Act (RWCA) funding on clinical and social outcomes in infants and children. Methods: An observational cohort study is planned of 350 children followed between 1985 -1999 in a pediatric infectious diseases clinic of a large urban hospital. The cohort will be stratified by phases of RWCA funding: pre-funding, program implementation, and program maturity; Computer databases supplemented by chart abstraction will provide information on visit/ hospitalization dates, lab values, illnesses, treatments, and clinical trials participation. Social work abstraction will identify visit dates, caregiver, client/other family needs, need type, social work activity, and date of problem resolution. Independent variables include: the three RWCA phases; Demographics (DOB, ethnicity, caregiver status); clinical care (treatment, clinic attendance, maternal use of AZT), and case management utilization and intensity. Outcomes include: clinical (slowed disease progression, increased survival, decreased number of hospitalizations/ opportunistic infections, and decline in perinatal infection); laboratory (CD4 count and low viral load maintenance and decline in viral load; and case management (access to services) variables. Within and between phase comparisons will be conducted. Analysis of temporal effects, including group-level associations of RWCA program implementation with clinical care and outcomes, and individual-level associations of case- management with clinical endpoints, will be performed using hierarchical regression procedures in the Poisson or logistic framework. The independent effect of changes in care will also be explored. Implications: The results will inform planning regarding structural approaches to HIV care that optimize clinical and social services outcomes.

Learning Objectives: At the end of this session, the participants will be able to: Evaluate methods of outcomes measurement; Assess the impact of secular trends on clinical care; and Assess the feasibility of using extant data for conducting a clinical outcomes study

Keywords: Outcomes Research, HIV/AIDS

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Lower NY Consortium for Families with HIV
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA