Washington state satellite HIV clinic program: a model for delivering highly effective decentralized care in under-resourced communities.
Washington state satellite HIV clinic program: a model for delivering highly effective decentralized care in under-resourced communities.
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DOI：
10.1080/09540121.2018.1481194
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发表时间：
2018-09
期刊：
影响因子：
1.7
通讯作者：
Harrington RD
中科院分区：
文献类型：
--
作者：
Wood BR;Bell C;Carr J;Aleshire R;Behrens CB;Dunaway SB;Shah JA;Barnabas RV;Green ML;Ramers CB;Fina PL;Kim HN;Harrington RD
为了改善西华盛顿州（WA）服务不足地区获得高质量艾滋病毒护理的机会，我们与WA州卫生部（DOH）和社区合作伙伴合作，推出了四个艾滋病毒卫星诊所。在这里，我们描述了这种创新的临床护理模式，提出了一个估计的成本，并评估病人的护理结果，包括病毒学抑制率。为了实现这一目标，我们评估了卫星诊所开业前12个月和开业后12个月的病毒学抑制率，比较了在卫星诊所登记的艾滋病毒感染者（PLWH）与同一地区未登记的所有PLWH。我们还确定了2015年的病毒学抑制率，比较了卫星诊所与非卫星诊所的患者，并比较了卫星诊所与母学术诊所之间的护理质量指标。结果表明，在卫星诊所开业前12个月至开业后12个月的病毒学抑制率变化中，参加卫星诊所的患者高于同一地区未参加卫星诊所的所有患者（18% vs 6%，p < 0.001）。2015年，卫星诊所的病毒学抑制率显著高于非卫星诊所患者。卫星诊所的护理质量指标达到了高水平，与母公司学术诊所相当。总体而言，通过社区伙伴关系和西澳大利亚卫生部的支持，卫星诊所方案增加了获得最佳做法艾滋病毒护理的机会，并提高了难以到达地区的病毒学抑制率。这一模式可以推广到艾滋病毒从业人员不足的其他区域，但需要财政支助。
To improve access to high-quality HIV care in underserved regions of Western Washington (WA) State, we collaborated with the WA State Department of Health (DOH) and community partners to launch four satellite HIV clinics. Here, we describe this innovative clinical care model, present an estimate of costs, and evaluate patient care outcomes, including virologic suppression rates. To accomplish this, we assessed virologic suppression rates 12 months before and 12 months after the satellite clinics opened, comparing people living with HIV (PLWH) who enrolled in the satellite clinics versus all PLWH in the same regions who did not. We also determined virologic suppression rates in 2015 comparing satellite clinic versus non-satellite clinic patients and compared care quality indicators between the satellite clinics and the parent academic clinic. Results demonstrate that the change in virologic suppression rate 12 months before to 12 months after the satellite clinics opened was higher for patients who enrolled in the satellite clinics compared to all those in the same region who did not (18% versus 6%, p < 0.001). Virologic suppression in 2015 was significantly higher for satellite clinic than non-satellite clinic patients at three of four sites. Care quality indicators were met at a high level at the satellite clinics, comparable to the parent academic clinic. Overall, through community partnerships and WA DOH support, the satellite clinic program increased access to best practice HIV care and improved virologic suppression rates in difficult-to-reach areas. This model could be expanded to other regions with inadequate access to HIV practitioners, though financial support is necessary.
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影响因子：
1.7
作者：
Wilson LE;Korthuis T;Fleishman JA;Conviser R;Lawrence PB;Moore RD;Gebo KA
通讯作者：
Gebo KA
DOI：
10.1097/qai.0000000000001483
发表时间：
2017-10-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Lopes BLW;Eron JJ Jr;Mugavero MJ;Miller WC;Napravnik S
通讯作者：
Napravnik S
DOI：
10.1093/cid/ciw442
发表时间：
2016-10-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Weiser J;Beer L;West BT;Duke CC;Gremel GW;Skarbinski J
通讯作者：
Skarbinski J
DOI：
10.1080/713612410
发表时间：
1998-06-01
影响因子：
1.7
作者：
Heckman, TG;Somlai, AM;Kelly, JA
通讯作者：
Kelly, JA
影响因子：
4.4
作者：
Ohl, Michael;Lund, Brian;Belperio, Pamela S.;Goetz, Matthew Bidwell;Rimland, David;Richardson, Kelly;Justice, Amy;Perencevich, Eli;Vaughan-Sarrazin, Mary
通讯作者：
Vaughan-Sarrazin, Mary