Measurement of retention in care among adults infected with HIV in an urban clinic
Measurement of retention in care among adults infected with HIV in an urban clinic
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DOI：
10.1080/09540121.2011.555942
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发表时间：
2011-01-01
影响因子：
1.7
通讯作者：
Schwartz, Rebecca M.
中科院分区：
文献类型：
--
作者：
Marx, Katherine A.;Malka, Edmond S.;Schwartz, Rebecca M.
感染艾滋病毒的成年人在接受定期医疗护理时寿命更长，但许多成年人没有继续接受护理。提供者衡量保留率，以评估改善艾滋病毒护理保留率和质量的干预措施。然而，有多种留住人才的措施。本研究比较了两种方法的可操作性保留，并评估个人特征的保留的可能性的贡献。图表审查进行了随机抽样的212个活跃的客户的城市艾滋病毒初级保健诊所。收集每个参与者的诊所利用率、性别、年龄、种族、精神疾病、物质使用、艾滋病诊断、语言和住房等数据。诊所利用数据被用来对参与者的保留状态进行分类，并根据访问频率对其进行评分。二元逻辑回归分析与有序逻辑回归分析进行了比较，使用不同的保留措施作为结果变量。在二元模型中，那些有物质使用史的人被保留的可能性约为一半（OR 0.52，95% CI 0.29-0.94），而那些被诊断为艾滋病的人被保留的可能性超过两倍（OR 2.18，95% CI 1.17-4.09）。这些特征在有序模型中是显著的预测因子，额外的发现是那些报告英语为主要语言的人不太可能有更高的保留分数（OR 0.40，95%CI 0.19-0.84）。保留的有序分数可以确定意想不到的预测因素，但保留的二分法措施可能更容易使用和解释参与保留相关的质量改进活动的提供者。
Adults infected with HIV live longer when they receive regular medical care, yet many adults are not retained in care. Providers measure retention in order to evaluate interventions to improve retention and quality of HIV care. However, multiple measures for retention exist. This study compares two methods of operationalizing retention and evaluates the contribution of individual characteristics on the likelihood of retention. A chart review was performed for a random sample of 212 active clients of an urban HIV primary care clinic. Data on clinic utilization, sex, age, race, mental illness, substance use, AIDS diagnosis, language, and housing were collected for each participant. Clinic utilization data were used to classify participants for retention status and to score them by frequency of visits. Binary logistic regression analysis was compared with ordinal logistic regression analysis, using distinct retention measures as outcome variables. In the binary model, those with a history of substance use were about half as likely to be retained (OR 0.52, 95% CI 0.29-0.94) and those with an AIDS diagnosis were more than twice as likely to be retained (OR 2.18, 95% CI 1.17-4.09). These characteristics were significant predictors in the ordinal model, with the additional finding that those reporting English as a primary language were less likely to have higher retention scores (OR 0.40, 95% CI 0.19-0.84). An ordinal score for retention can identify unexpected predictors, but a dichotomous measure of retention may be easier to use and interpret for providers involved in retention-related quality improvement activities.