HIV-related medical service use by rural/urban residents: a multistate perspective.

Objective: Geographic location may be related to the receipt of quality HIV health care services. Clinical outcomes and health care utilization were evaluated in rural, urban, and peri-urban patients seen at high-volume US urban-based HIV care sites.

Methods: Zip codes for 8773 HIV patients followed in 2005 at seven HIV Research Network sites were categorized as rural (population <10,000), peri-urban (10,000-100,000), and urban (>100,000).

Contemporary costs of HIV healthcare in the HAART era.

Background: The delivery of HIV healthcare historically has been expensive. The most recent national data regarding HIV healthcare costs were from 1996-1998. We provide updated estimates of expenditures for HIV management.

Associations between outpatient and inpatient service use among persons with HIV infection: a positive or negative relationship?

Objective: To examine the prospective association between frequency of outpatient visits and subsequent inpatient admissions.

Data Sources: Medical record data on 13,942 patients with HIV infection seen in 10 HIV speciality care sites across the United States.

Study Design: This observational study followed a cohort of HIV-infected patients who were in care in the first half of 2001.

Catalyzing system changes to make HIV care more accessible.

Although a comprehensive evaluation of the Care System Assessment Project is still several years off, the project quickly catalyzed changes in each of the communities in which it was piloted. All the sites found the system assessment model useful in identifying gaps in services. The project also clarified ways to engage underserved minorities in both care and planning for HIV care, and it helped to create community consensus in shaping initiatives to bring these populations into care.

Adapting RARE to assess barriers to service receipt among people out of care.

This paper describes the components of Rapid Assessment, Response and Evaluation (RARE), developed for HIV prevention planning; the adaptation of its methods to services planning; the venues in which the use of RARE was recommended for the present Care System Assessment Demonstration Project; constraints on what projects using RARE and the system assessment model may expect to accomplish; the focus of RARE questions for the project, concerning the characteristics of PLWH not in regular primary care, the care system as PLWH not in care perceive and experience it, and characteristics of the physical and social environments in which they live; how information from RARE can contribute to the enhancement of care systems; and the types of questions that sites could ask to gather RARE information for services planning.