"Information technology promises to improve health care through reporting of standardized quality-of-care measures. In 2008, the National Quality Forum (NQF) first endorsed performance measures for human immunodeficiency virus (HIV)/AIDS care. Little is known about performance on these measures in routine medical practice," the authors wrote in introducing the current study. Advertisement
The team assessed performance using available electronic data for the large, diverse population with HIV in the Department of Veterans Affairs (VA) and evaluated the influence of patient and resource factors.
In a retrospective analysis of observational data for 21,564 HIV patients receiving care through the VA in 2008, the investigators determined performance rates for 10 NQF measures for HIV/AIDS care for the VA nationwide and for 73 facilities with caseloads of 100 or more HIV patients.
"National rates for six measures were greater than 80 percent; the remaining measures and their rates were as follows: annual syphilis screening (54 percent), tuberculosis screening (65 percent), pnuemocystis pneumonia prophylaxis (72 percent), and HIV RNA control (73 percent)," according to the results. Rates varied for all measures across facilities. Multivariate logistic regression models showed African Americans and hard-drug users were less likely to access care and less likely to receive HIV-specific care but more likely to receive indicated general medical treatment. Resource factors -- number of primary care/infectious disease outpatient visits, duration of care, and larger facility caseload -- were associated with greater likelihood of receipt of indicated general and HIV-specific care.
"National performance rates were generally high, but variations in rates across facilities revealed room for improvement," concluded the investigators. "Both patient and resource factors had an impact on the likelihood of receipt of indicated care."
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