IMPROVING HEALTH CARE UTILIZATION IN HIV+ DRUG USERS

提高艾滋病毒吸毒者的医疗保健利用率

• 批准号: 6312558
• 负责人: KELLY A GEBO
• 金额: $ 15.31万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-01 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6312558
• 关键词: AIDS; HIV infections; behavioral /social science research tag; clinical research; data collection methodology /evaluation; disease /disorder prevention /control; drug abuse prevention; drug abuse therapy; health behavior; health care referral /consultation; health care service utilization; health economics; health education; health services research tag; hospital utilization; human data; patient care management; patient care planning; statistics /biometry; substance abuse related disorder

Dr. Gebo is a Robert Wood Johnson Clinical Scholar and will be an infectious disease fellow at the Johns Hopkins University (2000-01). She has spent the past two years conducting epidemiologic and health services outcomes research for individuals with HIV, many of whom are drug users. Through this award, Dr. Gebo would like to conduct health services research on the interaction of drug abuse and HIV infection, as a faculty member in Infectious Diseases at Johns Hopkins. She will have the mentorship of Drs. Richard Moore and Neil Powe, experts in HIV epidemiologic and health services research, as well as the collaboration of Drs. Mary McCaul and Barbara Turner, established researchers in drug abuse and HIV health services utilization of drug users. To complement her research, Dr. Gebo will complete courses in the School of Public Health in substance abuse, ethics, and advanced biostatistics and health services research methods. Protease inhibitors were shown to decrease morbidity and mortality in HIV+ patients. In pilot data, Dr. Gebo found that hospitalization rates in our HIV+ patients decreased significantly between 1995 and 1997; however, this trend was markedly attenuated in patients with a history of illicit drug use. Illicit drug use is strongly associated with hospitalization among HIV+ patients, even after adjustment for antiretroviral use. To explore this, Dr. Gebo will perform a cohort study on patients followed in the Johns Hopkins HIV clinic where she will examine hospitalization and outpatient care utilization rates, in a time-series analysis, between 1998 and 2001. She will also conduct a cross-sectional study of patients enrolled in the Johns Hopkins HIV Clinic in 2001 to examine the adequacy of preventive care utilization. After assessing utilization patterns, she will conduct an intervention of intensive case management in substance abusing patients to increase substance abuse treatment and decrease substance use. Finally, she will conduct a cost-effectiveness analysis of the intervention. The goals of the award are to identify areas of over and under utilization of health care by HIV+ patients, and to increase completion of substance abuse treatment referrals and decrease overall substance use in HIV+ drug users. The combination of research utilizing existing data sources, as well as intervention planning and primary data collection, the excellent mentorship of senior scientists, the coursework available, and the supportive environment of the Johns Hopkins University will provide Dr. Gebo the skills she needs to develop into an independent clinician researcher in HIV epidemiologic and health services research.

Gebo博士是罗伯特·伍德约翰逊临床学者，将成为约翰霍普金斯大学（2000-01）的传染病研究员。过去两年，她一直在为艾滋病毒感染者（其中许多人是吸毒者）进行流行病学和卫生服务成果研究。通过这一奖项，Gebo博士希望作为约翰霍普金斯大学传染病系的一名教员，对药物滥用和艾滋病毒感染的相互作用进行卫生服务研究。她将得到艾滋病毒流行病学和卫生服务研究专家理查德摩尔博士和尼尔·泰勒博士的指导，以及玛丽·麦考尔博士和芭芭拉·特纳博士的合作，他们是吸毒者滥用药物和艾滋病毒卫生服务利用方面的知名研究人员。为了补充她的研究，Gebo博士将在公共卫生学院完成药物滥用，道德，先进的生物统计学和卫生服务研究方法的课程。蛋白酶抑制剂被证明可以降低HIV+患者的发病率和死亡率。在试点数据中，Gebo博士发现，1995年至1997年期间，我们的HIV阳性患者的住院率显著下降;然而，在有非法药物使用史的患者中，这一趋势明显减弱。非法药物使用与艾滋病毒阳性患者住院密切相关，即使在调整抗逆转录病毒药物使用后也是如此。为了探索这一点，Gebo博士将对在约翰霍普金斯艾滋病诊所接受随访的患者进行一项队列研究，她将在1998年至2001年期间对住院和门诊治疗利用率进行时间序列分析。她还将对2001年在约翰霍普金斯艾滋病诊所登记的病人进行一项横断面研究，以检查预防保健利用的充分性。在评估利用模式后，她将对药物滥用患者进行强化病例管理干预，以增加药物滥用治疗和减少药物使用。最后，她将对干预措施进行成本效益分析。该奖项的目标是确定艾滋病毒阳性患者过度和不足利用医疗保健的领域，提高药物滥用治疗转诊的完成率，减少艾滋病毒阳性吸毒者的总体药物使用。利用现有数据源的研究，以及干预计划和主要数据收集，高级科学家的优秀指导，可用的课程，以及约翰霍普金斯大学的支持性环境的组合将为Gebo博士提供她发展成为HIV流行病学和卫生服务研究的独立临床研究员所需的技能。