HIV Positive Clinical Trial
Official title:
Measuring HIV Quality of Care
The VA is the largest single provider of HIV care in the United States. The late 1990's have seen a revolution in the quality standards for this disease with the onset of Highly Active Antiretroviral Therapy (HAART) and other developments.
Background:
The VA is the largest single provider of HIV care in the United States. The late 1990's have
seen a revolution in the quality standards for this disease with the onset of Highly Active
Antiretroviral Therapy (HAART) and other developments.
Objectives:
Our purpose in this project is to develop a method for assessing quality in two important
areas of HIV care - antiretroviral medications and opportunistic infection screening and
prophylaxis - and explore the determinants of high quality care in order to suggest quality
improvement strategies.
Methods:
The analysis has four parts. First, it will describe the level of adherence to the
indicators in VA HIV patients nationwide and compare VA HIV patients to national benchmarks.
Second, it will analyze facility and patient level predictors of adherence to indicators of
quality of care and compare them with the predictors in the non VA population using staged
logistic regressions. Third, it will seek to validate certain indicators (e.g. HAART
therapy) against clinical outcomes like hospitalization and immune status. We will also
model the clinical "price" that the VA pays in suboptimal clinical outcomes as a result of
current performance levels. Fourth, we will compare the performance of the facilities after
one year of an intensive targeted indicator-specific feedback group versus those receiving
aggregate data only.
Status:
Data analysis.
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N/A
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