Evaluating HIV pre-exposure prophylaxis implementation using an all payers claims database

使用所有付款人索赔数据库评估 HIV 暴露前预防的实施情况

• 批准号: 9345007
• 负责人: Philip Andrew Chan
• 金额: $ 20.03万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9345007
• 关键词: AIDS/HIV problem; Adopted; Affect; African American; Algorithms; Big Data; Caring; Characteristics; Cost Sharing; Cost-Sharing Insurance; Country; Data; Data Sources; Databases; Deductibles; Development; Epidemic; Future; Goals; HIV; HIV Infections; Insurance; Insurance Carriers; Insurance Coverage; Intervention; Lead; Measures; Medicaid; Medicare; Methods; Monitor; Outcome; Patients; Physicians; Play; Policies; Population; Populations at Risk; Primary Care Physician; Privatization; Provider; Research; Resources; Rhode Island; Risk; Role; Testing; Time; United States; United States National Institutes of Health; Variant; Work; base; cost; demographics; federal policy; high risk population; improved; men who have sex with men; novel; pre-exposure prophylaxis; prevent; programs; racial disparity; racial minority; scale up; therapy development; uptake

PROJECT SUMMARY The HIV epidemic continues to disproportionately impact men who have sex with men (MSM) and African American populations in the United States (US). Pre-exposure prophylaxis (PrEP) has demonstrated efficacy in preventing HIV acquisition among at-risk populations. Despite high efficacy, PrEP implementation across the US has been slow, and approaches to evaluate implementation and determine gaps in coverage have been limited. The goal of this study is to evaluate and inform PrEP implementation efforts with a novel “big data” approach using the Rhode Island All Payers Claims Database (APCD). APCDs are an emerging data source that contain insurance claims from Medicaid, Medicare, and most, if not all, private insurers. Rhode Island is one of the first states in the country to adopt an APCD. This study will develop and validate an algorithm to measure PrEP uptake and persistence using the RI APCD (Aim 1), describe PrEP implementation across the state including which physicians are prescribing PrEP and characteristics of the patients PrEP is being prescribed to (Aim 2), and assess the impact of insurance cost-sharing (e.g. co-pays, deductibles, and co-insurance) on PrEP uptake and persistence (Aim 3). Results of this study will provide the groundwork for the development of structural-level interventions to promote PrEP uptake among high-risk populations and inform state and federal policies pertaining to PrEP implementation.

项目概要 艾滋病毒流行继续对男男性行为者 (MSM) 和男男性行为者产生不成比例的影响 美国 (US) 的非裔美国人人口。暴露前预防 (PrEP) 已被证明 预防高危人群感染艾滋病毒的功效。尽管功效很高，但 PrEP 的实施 美国各地的进展缓慢，评估实施情况和确定覆盖范围差距的方法 已受到限制。本研究的目的是通过一种新颖的方法来评估 PrEP 的实施工作并为其提供信息 使用罗德岛州所有付款人索赔数据库 (APCD) 的“大数据”方法。 APCD是一种新兴的 包含医疗补助、医疗保险和大多数（如果不是全部）私人保险公司的保险索赔的数据源。 罗德岛州是美国最早采用 APCD 的州之一。这项研究将开发并验证 使用 RI APCD 测量 PrEP 摄取和持久性的算法（目标 1），描述 PrEP 实施 全州范围内，包括哪些医生正在开 PrEP 处方以及患者的特征 PrEP 是 规定（目标 2），并评估保险费用分摊的影响（例如自付额、免赔额和 PrEP 的采用和持久性（目标 3）。这项研究的结果将为 制定结构层面的干预措施，以促进高危人群对 PrEP 的吸收，以及 告知有关 PrEP 实施的州和联邦政策。