Defining Care Patterns and Outcomes Among Persons Living with HIV in Washington, DC: Linkage of Clinical Cohort and Surveillance Data
Defining Care Patterns and Outcomes Among Persons Living with HIV in Washington, DC: Linkage of Clinical Cohort and Surveillance Data
复制标题
DOI：
10.2196/publichealth.9221
复制
发表时间：
2018-01-01
影响因子：
8.5
通讯作者：
Greenberg, Alan
中科院分区：
文献类型：
--
作者：
Castel, Amanda D.;Terzian, Arpi;Greenberg, Alan
背景资料：对来自多个来源的数据（如临床队列和监测数据）进行三角分析，有助于提高我们描述护理模式、服务利用率、合并症的能力，并最终衡量和监测艾滋病毒感染者的临床结果。本研究的目的是确定临床队列数据和常规收集的HIV监测数据之间的联系是否会提高每个数据的完整性和准确性。方法：我们将来自哥伦比亚特区（DC）队列（一个大型HIV观察性临床队列）的数据与华盛顿特区卫生部（DOH）2011年1月至2015年6月的监测数据联系起来。我们使用Kappa检验统计量确定了链接前和链接后数据库中选定变量之间的一致性百分比。我们比较了保留护理（RIC）、病毒抑制（VS）、性传播疾病（STD）和非HIV共病（如高血压），并使用卡方检验比较了使用前链接数据库（DC队列）与后链接数据库（DC队列+DOH）确定的HIV诊所就诊模式。此外，我们比较了在≥ 3个地点接受艾滋病毒护理的参与者的社会人口学特征、RIC和VS，而在≥ 3个护理地点接受艾滋病毒护理的参与者更有可能有不稳定的住房（15.1%，64/424 vs 8.96%，380/4242），公共保险（86.1%，365/424 vs 57.57%，2442/4242），共病（如高血压）（37.7%，160/424vs22.98%，975/4242），有获得性免疫缺陷综合征（77.8%，330/424vs61.20%，2596/4242）（均P
Background: Triangulation of data from multiple sources such as clinical cohort and surveillance data can help improve our ability to describe care patterns, service utilization, comorbidities, and ultimately measure and monitor clinical outcomes among persons living with HIV infection.Objectives: The objective of this study was to determine whether linkage of clinical cohort data and routinely collected HIV surveillance data would enhance the completeness and accuracy of each database and improve the understanding of care patterns and clinical outcomes.Methods: We linked data from the District of Columbia (DC) Cohort, a large HIV observational clinical cohort, with Washington, DC, Department of Health (DOH) surveillance data between January 2011 and June 2015. We determined percent concordance between select variables in the pre- and postlinked databases using kappa test statistics. We compared retention in care (RIC), viral suppression (VS), sexually transmitted diseases (STDs), and non-HIV comorbid conditions (eg, hypertension) and compared HIV clinic visit patterns determined using the prelinked database (DC Cohort) versus the postlinked database (DC Cohort + DOH) using chi-square testing. Additionally, we compared sociodemographic characteristics, RIC, and VS among participants receiving HIV care at =3 sites versus = 3 care sites were more likely to have unstable housing (15.1%, 64/424 vs 8.96%, 380/4242), public insurance (86.1%, 365/424 vs 57.57%, 2442/4242), comorbid conditions (eg, hypertension) (37.7%, 160/424 vs 22.98%, 975/4242), and have acquired immunodeficiency syndrome (77.8%, 330/424 vs 61.20%, 2596/4242) (all P