Andersen Marcia, Tinsley Jannie, Milfort Dollie, Wilcox Robert, Smereck Geoffrey, Pfoutz Susan, Creech Steve, Mood Darlene, Smith Teresa, Adams Latonia, Thomas Richard, Connelly Christopher
Well-Being Institute, Inc., Detroit, Michigan, USA.
AIDS Patient Care STDS. 2005 Jul;19(7):449-59. doi: 10.1089/apc.2005.19.449.
Nurses at the Well-Being Institute, a community-based nursing outreach clinic in Detroit, Michigan, located 75 women living with HIV, mental illness, and substance abuse who were lost to follow-up at their HIV medical clinic as part of a nursing research study. Women who had been scheduled for an appointment in the last 4 months but who had missed that appointment were considered "lost to follow-up" in the HIV clinic. The purpose of the research was to study factors related to health care access in women not participating in regular health care for their HIV infection. Women were randomly assigned to two study groups. Women assigned to "care as usual" study group (n = 37) received no additional services beyond study interviews for 1 year. Women assigned to the "nursing intervention" group (n = 38) were provided with nursing services designed to facilitate their return to and continued connection with their HIV clinic. Findings showed that factors related to the women's vulnerability, such as mental illness and drug use, were more related to their use of expensive health care services such as hospital emergency departments or hospital inpatient admissions than was assignment to either the "nursing intervention" or "care as usual" study groups. Two case studies describing the cost of care for 2 of the multiply diagnosed women in the study is presented. The women differed on whether they had stable housing and were accessing care for their mental illness.
位于密歇根州底特律的一家社区护理外展诊所——幸福研究所的护士，在一项护理研究中，找到了75名感染艾滋病毒、患有精神疾病且有药物滥用问题的女性，她们在艾滋病毒医疗诊所失去了随访。在艾滋病毒诊所，那些在过去4个月内已预约但错过预约的女性被视为“失去随访”。该研究的目的是研究未参与艾滋病毒感染常规医疗保健的女性中与医疗保健可及性相关的因素。女性被随机分配到两个研究组。被分配到“照常护理”研究组（n = 37）的女性在1年内除了研究访谈外没有接受额外服务。被分配到“护理干预”组（n = 38）的女性获得了旨在帮助她们重返艾滋病毒诊所并持续保持联系的护理服务。研究结果表明，与女性脆弱性相关的因素，如精神疾病和药物使用，与她们使用昂贵的医疗保健服务（如医院急诊科或医院住院治疗）的关联，比与被分配到“护理干预”或“照常护理”研究组的关联更大。本文呈现了两个案例研究，描述了该研究中2名多重诊断女性的护理费用。这两名女性在是否有稳定住房以及是否接受精神疾病治疗方面存在差异。
