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、 艾滋病毒患者需要与这些相关的准确信息 医疗服务的提供、资金来源和患者的趋势 结果。在国家一级进行公正的估计，对于 对感兴趣人群的统计推断，目前是 缺乏。因此，我们建议与AHCPR合作收集 关于全国艾滋病毒/艾滋病患者及其概率抽样的数据 供应商。这项研究将招募4000名随机选择的受试者 在18个州和哥伦比亚特区接受大约60人的护理 主要供应商和120家较小供应商，分布在30个随机选择的区域 3有目的地选择农村补充地点。数据收集将 由基线访谈、6、12和18岁的后续访谈组成 月，医疗(一两次)和帐单记录摘要 有关利用率、成本和严重性的数据。 研究团队包括：兰德、NORC、希望工程、 哈佛·布朗大学、迈阿密大学和波士顿大学，明尼苏达州杰斐逊西奈半岛和 查尔斯·德鲁医学院，加州大学洛杉矶分校，加州大学洛杉矶分校，旧金山分校 公共卫生、北加州凯撒-永久医院和其他 各机构以及社区中主要的艾滋病毒/艾滋病提供者 抽样人员将协助执行研究并参与 学术著作。艾滋病毒社区的成员将在 这个项目。为促进与AHCPR的合作，所有主要会议 研究团队、社区会议和科学咨询 小组会议将在华盛顿举行。 该项目将检查医疗和非医疗的使用和成本 以及它们在不同的地理位置、不同的医疗保健系统和 患者的临床和人口学特征；检查在 获得护理、未得到满足的服务需求、与健康有关的生活质量、 社会支持、护理质量、临床流行病学、满意度 关心和了解艾滋病毒/艾滋病；验证严重程度和 分期；评估主要护理提供者和行为的过渡 有关妇女感染爱滋病病毒的特别研究(两次抽样 男子比率(n=400)和儿童(n=400)，农村(n=400) 保健和牙科护理，以及正式和非正式护理人员。我们会 估计艾滋病毒治疗的终生成本和医疗改革的影响 和治疗进展，以及分析ACSUS数据以提供 与以前的工作保持连续性。这些数据将为国家提供 对艾滋病毒影响的估计可以回答广泛的问题 并将允许分析不同地点的护理情况，包括 在疫情的前沿。这些数据将提供给 公众使用，该项目的调查人员将迅速做出反应 与政策有关的对数据和其他研究的要求。

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.