Outcome Evaluation of Minority AIDS Initiative Programs in the New York EMA
Summary
This outcome evaluation effort provides the opportunity to learn what programmatic approaches effectively address two of the most difficult hurdles in HIV health services delivery: (1) getting people who would benefit from health care to use it and (2) getting people who do use health care to do so more consistently and effectively. The New York HIV Planning Council (through MHRA) has funded 23 agencies to achieve these objectives for people of color with HIV disease.
Description
All clients are assessed upon entry into the program, have their service utilization tracked, and then are reassessed at three, six, and twelve months following program entry.
The main client-level data elements collected during baseline and follow-up interviews are the following:
- Biological markers (including HIV status, viral load, t-cell count)
- Demographic characteristics
- Adherence to treatment
- Barriers to care
- Social support
- Substance use and treatment
- Functional health status
Functional Health Status is used in this evaluation as the primary measure of final client “outcomes.” The Functional Health Status items we use are from the ACTG SF-21 (a modified version of the Medical Outcomes Study instrument).
The overall evaluation objectives are to:
- Describe the change in functional health status for different populations and groups of clients.
- Identify services or constellations of services and intensity of services associated with change in functional health status.
- Assess whether programs meet intermediate objectives (decreased drug use, increased service use, improved housing stability).
- Identify barriers to access to and maintenance in care.
Study Design
Allocation: Non-Randomized, Control: Uncontrolled, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
HIV Infections
Intervention
Maintenance in Care Services, Access to Care Services
Location
Bronx Lebanon Hospital Center
Bronx
New York
United States
10457
Status
Recruiting
Source
The New York Academy of Medicine
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00273403
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Health Maintenance Organizations
Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)
Gatekeeping
The controlling of access to health services, usually by primary care providers; often used in managed care settings to reduce utilization of expensive services and reduce referrals. (From BIOETHICS Thesaurus, 1999)
Home Care Services
Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.
Intermediate Care Facilities
Institutions which provide health-related care and services to individuals who do not require the degree of care which hospitals or skilled nursing facilities provide, but because of their physical or mental condition require care and services above the level of room and board.
Ancillary Services, Hospital
Those support services other than room, board, and medical and nursing services that are provided to hospital patients in the course of care. They include such services as laboratory, radiology, pharmacy, and physical therapy services.
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