HIV COST AND SERVICES UTILIZATION STUDY (HCSUS)

艾滋病毒/艾滋病日益成为弱势群体的一种疾病;护理工作正在进行 从主要的震中和治疗中心转移到分散的 社区和实践环境。 政策制定者，医疗保健提供者， 艾滋病患者需要与这些相关的准确信息， 提供护理的趋势、资金来源和患者 结果。 国家一级的无偏估计数， 对感兴趣人群的统计推断，目前是 缺乏 因此，我们建议与AHCPR合作， 关于艾滋病毒/艾滋病感染者及其 提供商 本研究将入组4000例随机选择的受试者 在18个州和哥伦比亚特区接受治疗的人从大约60人 主要和120个较小的供应商在30个随机选择的地区， 三是有针对性地选择农村地区。 数据收集将 包括基线访谈，6岁、12岁和18岁的随访访谈， 月，医疗（1或2次）和账单记录摘要 获取有关利用率、成本和严重程度的数据。 研究团队包括：来自兰德、NORC、Project HOPE、 哈佛布朗大学、迈阿密大学和波士顿大学，杰斐逊山。西奈和 查尔斯德鲁医学院，加州大学洛杉矶分校，加州大学圣地亚哥分校，旧金山弗朗西斯科系 公共卫生，北方加州的Kaiser-Permanente，以及其他 艾滋病毒/艾滋病防治机构以及社区的主要提供者 将协助研究执行并参与 学术工作。 艾滋病毒社区的成员将在以下方面发挥重要作用： 该项目 为了促进与人权事务高级专员办事处的合作， 研究小组的会议、社区会议和科学咨询会议 将在华盛顿举行。 该项目将研究医疗和非医疗的使用和成本 服务以及它们在地理上、在医疗保健系统中以及 患者临床和人口统计学特征;检查 获得保健、未满足的服务需求、与健康有关的生活质量， 社会支持，照护品质，临床流行病学，满意度 艾滋病毒/艾滋病的护理和知识;验证严重程度的衡量标准， 分期;评估主要护理提供者的过渡，并进行 关于妇女艾滋病毒感染情况的特别研究（将在2009年2月20日至2009年3月30日期间 农村地区（n=400），男性（n = 400）和儿童（n=400）的心理健康状况 保健和牙科护理以及正式和非正式护理人员的情况。 我们将 估计艾滋病毒治疗的终生费用和卫生改革的影响 和治疗进展，以及分析ACSUS数据， 与以前的工作保持一致。 这些数据将为国家 估计艾滋病毒的影响，可以回答广泛的问题， 并将允许分析护理如何在不同的网站，包括那些 在流行病的前沿。 数据将提供给 公众使用，该项目的调查人员将迅速作出反应， 与政策有关的数据和其他研究要求。

HIV/AIDS is increasingly a disease of the disadvantaged; care is moving out of the major epicenters and treatment centers into dispersed communities and practice settings. Policymakers, health care providers, and HIV patients need accurate information that is relevant to these trends on the delivery of care, sources of financing, and patient outcomes. Unbiased estimates at the national level, necessary for statistical inferences to the population of interest, currently are lacking. Therefore, we propose to cooperate with AHCPR in collecting data on a national probability sample of persons with HIV/AIDS and their providers. The study will enroll 4000 randomly-selected subjects receiving care in 18 states and the District of Columbia from about 60 major and 120 smaller providers in 30 randomly-selected locales and from 3 purposefully-selected supplemental rural sites. Data collection will consist of a baseline interview, follow-up interviews at 6, 12 and 18 months, and medical (on 1 or 2 occasions) and billing record abstraction for data on utilization, costs and severity. The research team includes: investigators from RAND, NORC, Project HOPE, Harvard Brown, Miami and Boston Universities, Jefferson, Mt. Sinai and Charles Drew Medical Colleges, UCLA, UCSD, San Francisco Department of Public Health, Kaiser-Permanente of Northern California, and other institutions, as well as leading HIV/AIDS providers in the communities sampled who will facilitate execution of the study and participate in scholarly work. Members of the HIV community will have a strong role in the project. To facilitate cooperation with AHCPR, all major meetings of the study team, and meetings of the community and scientific advisory panels, will be held in Washington. This project will examine use and costs of medical and nonmedical services and how they vary geographically, across health care systems and patient clinical and demographic characteristics; examine variations in access to care, unmet needs for services, health-related quality of life, social support, quality of care, clinical epidemiology, satisfaction with care and knowledge about HIV/AIDS; validate measures of severity and staging; evaluate transitions in principal provider of care, and conduct special studies on HIV infection among women (to be sampled at twice the rate of men) and children (n=400), in rural areas (n=400), on mental health and dental care, and on formal and informal caregivers. We will estimate lifetimes costs of HIV treatment and the impact of health reform and therapeutic advances, as well as analyze ACSUS data to provide continuity with previous work. These data will provide national estimates of the impact of HIV that can answer a broad range of questions and will allow analyses of how care varies across sites, including those at the frontiers of the epidemic. The data will be made available for public use, and the project's investigators will respond rapidly to policy-related requests for data and additional studies.