Evaluating HIV Surveillance Completeness Along the Continuum of Care: Supplementing Surveillance With Health Center Data to Increase HIV Data to Care Efficiency
Evaluating HIV Surveillance Completeness Along the Continuum of Care: Supplementing Surveillance With Health Center Data to Increase HIV Data to Care Efficiency
复制标题
DOI：
10.1097/qai.0000000000001970
复制
发表时间：
2019-09-01
影响因子：
3.6
通讯作者：
Flynn, Colin P.
中科院分区：
文献类型：
--
作者：
Arey, Alyssa L.;Cassidy-Stewart, Hope;Flynn, Colin P.
背景：艾滋病毒监测对于量化流行病的影响和制定艾滋病毒方案至关重要。马里兰州卫生部（MDH）历史上进行了艾滋病毒数据护理（D2C）活动，使用监测数据，以确定个人谁是没有在艾滋病毒护理;然而，大多数病例调查的结论是，个人的问题，目前正在从事护理。这表明，在实验室向艾滋病毒监测报告方面存在延误和差距，真正接受护理的艾滋病毒阳性马里兰人的比例被低估。因此，仅仅依靠监测数据可能不是识别非护理HIV病例的有效方法。设置：通过护理伙伴关系（P4 C）项目，MDH对来自4个卫生中心的HIV患者进行了有针对性的D2C工作。MDH在P4 C期间创建的扩展D2C模型将临床数据作为辅助数据源进行整合，以增强用于估计HIV患者护理的监测数据订婚MDH匹配和比较健康中心的电子健康记录与艾滋病毒监测数据，以评估艾滋病毒病例和实验室reporting.Results的完整性：艾滋病毒病例确认是高（99.9%）的P4 C队列（N = 927），但估计的护理参与和病毒抑制数据源之间的差异显示不完整的实验室报告和患者接受多个供应商的护理。分析临床数据导致几个报告差距，随着时间的推移，提高了监测数据的质量决议。结论：卫生部门应验证其HIV监测的完整性。将监测数据与临床数据进行三角分析，可以更准确地预测护理参与情况，并提高D2C效率。
Background: HIV surveillance is essential to quantifying the impact of the epidemic and shaping HIV programs. The Maryland Department of Health (MDH) historically conducted HIV Data to Care (D2C) activities using surveillance data to identify individuals who were not in HIV care; however, most case investigations concluded that the individuals in question were currently engaged in care. This suggests that delays and gaps in laboratory reporting to HIV surveillance exist and the proportion of HIV-positive Marylanders who are truly in care is underestimated. Therefore, solely relying on surveillance data might not be an efficient method for identifying not in care HIV cases.Setting: Through the Partnerships for Care (P4C) project, MDH conducted targeted D2C efforts on HIV patients from 4 health centers.Methods: The expanded D2C model that MDH created during P4C integrated clinical data as a secondary data source to enhance the surveillance data used to estimate HIV patient care engagement. MDH matched and compared health center electronic health records with HIV surveillance data to assess completeness of HIV case and laboratory reporting.Results: HIV case ascertainment was high (99.9%) for the P4C cohort (N = 927), but differences in estimated care engagement and viral suppression between data sources revealed incomplete laboratory reporting and that patients received care from multiple providers. Analyzing the clinical data leads to the resolution of several reporting gaps, which improved surveillance data quality over time.Conclusions: Health departments should validate their HIV surveillance completeness. Triangulating surveillance data with clinical data generated more accurate depictions of care engagement and increased D2C efficiency.