Retention Challenges for HIV-Infected Primary Care Patients 2001-2004 [United States]

This project examined HIV-infected patients who were lost to follow-up during calendar years 2001-2004 in order to identify reasons patients were leaving care. Sustaining and retaining HIV-infected patients in care has been a consistent challenge to primary care health systems. Continuity, enhancing wellness, and patient engagement are long-term goals in primary care. Factors that influence clients to disengage from care frequently result in patterns of episodic utilization that may compromise the patient's health status and increase their psychosocial vulnerability. The standard of care suggests that HIV-infected patients return for medical follow-up primary care visits four times a year. Since 2001, there have been over 495 patients that have been determined inactive. The project administered telephone and mail surveys to HIV-infected patients that no longer receive care at Fenway Health Center. The survey includes demographic questions, insurance questions, potential reasons for stopping care, and whether the participant is receiving care at another facility. Subsequently, the project connected interviewees into the Health System Navigation (HSN) Project to assist them with seeking HIV medical care. This was accomplished by including prescreener questions in the survey. If a patient is determined to be eligible, they will be invited to participate in the HSN Project.

本项目针对2001-2004年期间失访（lost to follow-up）的HIV感染患者展开研究，旨在明确患者中断护理的原因。在初级保健系统中维持并留住HIV感染患者始终是一项持续的挑战。连续性、健康促进与患者参与是初级保健的长期目标。影响患者脱离护理的因素往往导致间歇性医疗利用（episodic utilization）模式，这可能损害患者的健康状况并加剧其心理社会脆弱性。护理标准建议HIV感染患者每年返回初级保健机构进行四次医疗随访。自2001年以来，已有超过495名患者被认定为失访（inactive）。本项目对不再在芬威健康中心（Fenway Health Center）接受护理的HIV感染患者开展了电话与邮件调查。调查内容涵盖人口统计学问题、保险相关问题、停止护理的潜在原因，以及参与者是否在其他机构接受护理。随后，本项目将受访者接入医疗系统导航项目（Health System Navigation, HSN），以协助他们寻求HIV医疗护理。这一目标通过在调查中加入预筛选问题得以实现。若患者被认定符合条件，则会被邀请参与HSN项目。