We examined access & retention in HIV primary care in 1997-8 via analysis of existing databases for 2,647 patients. Support services(SS) included case management(CM), mental health(MH), chemical dependency(CD), & transportation(TRANS). 31.7% were women, 71% African American, 30% IDU, mean age 38, 61% uninsured. Mean Year 1 clinic visits were five. 23% of pts had <2 visits, & 31% had >8. Pts receiving SS included CM:1,617; MH:804; CD:420; TRANS:538; substantial need for SS was found & incompletely met. Multivariate analysis with logistic regression showed pts receiving CM (p=0.0003), MH (p=0.0005), TRANS (p<0.00005)& CD (p=0.036)were more likely to receive regular care in both years; mean & median total visits were 5 & 4 for NO CM and 9 & 7 for CM; 6 & 5 for NO TRANS and 10 & 9 for TRANS; 7 & 5 for NO MH & 9 & 9 for MH; 7 & 5 for NO CD & 10 & 9 for CD. As age increased, the likelihood of any care & regular care increased in both years. Women, IDUs & uninsured were less likely to receive regular care & had fewer visits in years 1 & 2 than men, non-IDUs & Medicaid or other payors. Conclusions: Support services supported by the Ryan White CARE Act correlate with significantly increased access and retention in HIV primary care. Younger adults, women, IDUs, & uninsured pts were less likely to receive regular care.
Learning Objectives: Participants will understand one study’s findings about the relationship between regular primary clinic visits, the role of ancillary services and improved health outcomes
Keywords: Access and Services, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The CORE Center of Cook County Hospital
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment