Development and Application of a Method to Assess Timeliness of Medical Care for HIV Symptoms

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• 作者：Amy M. Kilbourne ; Steven Asch ; Ronald M. Andersen ; Terry Nakazono ; Allen L. Gifford ; Samuel A. Bozzette ; Michael D. Stein ; Stephen Crystal ; Martin F. Shapiro and William E. Cunningham
• 关键词：access to care ; provider perceptions ; symptoms ; HIV
• 刊名：Health Services and Outcomes Research Methodology
• 出版年：2001
• 出版时间：2001
• 年：2001
• 卷：2
• 期：2
• 页码：101-115
• 全文大小：101 KB

文摘

Timely access to medical care is important for HIV+ individuals. Standards of care are needed that identify inappropriate delays in receiving care for serious symptoms. We evaluated the reliability and construct validity of provider-based standards for timely care for HIV symptoms, and applied these standards to data from the HIV Cost and Services Utilization Study (HCSUS), a national probability sample of HIV+ persons in care. HIV physicians estimated appropriate time to care HIV+ individuals should receive for headache, cough, diarrhea, or weight loss. Timely care was defined as receiving care by the mean provider-specified acceptable number of days to care, by specific CD4 count, compared to receiving care after the mean days to care. Sensitivity analyses were performed on the provider standards. Inter-rater reliability between physicians for timely care estimates was high (0.97). Up to 70 % of HIV+ individuals from the HCSUS survey did not receive timely care for their most bothersome symptom. Physicians rated patients with lower CD4 counts (