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APHA Scientific Session and Event Listing

Shazia Kazi, MD, MPH¹, Ralph Brisueno¹, Alberta Lin. Ferrari, MD¹, and Shahdokht Baroumand, DMD, MPH². (1) Baltimore City Health Department, Ryan White Title I Office, 210 Guilford Ave, 3rd floor, Baltimore, MD 21202, 410-396-1408, shazia.kazi@baltimorecity.gov, (2) National Institute of Health, Department of Clinical Research & Health Promotion, 45 Center Drive, Bethesda, MD 20892

Background: The Ryan White CARE Act as amended in FY 2000 requires Title I Grantees to implement and conduct a Quality Improvement Program. In accordance with this legislated requirement, the Baltimore City Health Department conducts onsite assessments of medical providers to ensure that services rendered are consistent with federal guidelines and best practices for the delivery of primary medical care. Fourteen organizations were funded in FY 2005 and provided comprehensive medical services to HIV infected clients in the Baltimore EMA (Eligible Metropolitan Area). Objective: The purpose of this study is to: 1) Evaluate the quality and compliance of Title I medical providers to current public health guidelines in the delivery of medial care services to HIV+ persons, and 2) Assess the wellness of consumers who receive primary care treatment through Ryan White funded service providers. Methodology: 537 medical charts were randomly reviewed based on a total number of (5516) clients served in 2005. The current Public Health Guidelines for HIV Medical Care were used to design a survey instrument that assessed four specific aspects of primary care treatment: 1) The frequency of primary care visits, 2) Initiation of HAART, 3) Annual medical screenings and prophylaxis therapy, and 4) Harm reduction interventions. Results: Ten data variables were used to measure the quality of care for the four aspects of primary medical care. These indicators include the number of clinic visits, clinical markers (CD4 count & Viral Load count), clients' HIV treatment status (HAART), evaluation for PCP/MAC prophylaxis, delivery of appropriate screenings, such as TB, Hepatitis, RPR, and the provision of safer sex education. For each of the elements reviewed, a quality score level is established that will reflect the proportion of clients assessed who satisfied the criteria. To further study the association between the variables, Chi-Square and Regression analysis will be used. Conclusion: The results of this evaluation will: 1) Guide the continuation of quality improvement initiatives in the Baltimore EMA, and 2) Validate the compliance of medical providers to public health guidelines and other local service requirements related to quality of care. This assessment will contribute towards increasing the system-wide capacity building of service providers to deliver quality primary care services in the EMA.

Learning Objectives:

• Understanding the data variables required in evaluating the quality of primary medical care provided by Title I programs to HIV infected clients. 2.Assess the overall health status of clients engaged in primary medical care after 1-year.
• Validate the compliance of providers to public health guidelines in the delivery of medical services to HIV infected clients.

Keywords: Ryan White, Quality

Presenting author's disclosure statement:

Not Answered

Handout (.pdf format, 1478.0 kb)

Handout (.ppt format, 415.0 kb)