Young Steven R, Conviser Richard, Marconi Katherine, Wieland Melanie K
Office of Science and Epidemiology, HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, MD 20857, USA.
J Health Soc Policy. 2003;17(4):1-14. doi: 10.1300/j045v17n04_01.
A recent study conducted by the Institute of Medicine concluded that there are approximately 1,200 to 1,400 avoidable deaths per year in the U.S. among people living with HIV (PLWH) who do not have health insurance (Institute of Medicine, 2002). The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was passed by the U.S. Congress in 1990 to provide funding for community-based HIV care services for uninsured and underinsured PLWH--the only Federal program to provide such funding. There is substantial local autonomy in the allocation of CARE Act funds, with planning processes that take place in both States and metropolitan areas. The purpose of this study is to examine trends in the allocation of such funds from 1996 through 2000, the first five years during which effective antiretroviral medications were available for HIV. The study also considers whether these trends were responsive to the evolving modalities of care and the service needs of a changing population of PLWH.
医学研究所最近进行的一项研究得出结论，在美国，每年约有1200至1400名未参加医疗保险的艾滋病毒感染者（PLWH）的死亡是可以避免的（医学研究所，2002年）。美国国会于1990年通过了《瑞安·怀特综合艾滋病资源紧急情况（CARE）法案》，为未参保和参保不足的艾滋病毒感染者提供基于社区的艾滋病毒护理服务资金——这是唯一提供此类资金的联邦项目。在CARE法案资金分配方面有很大的地方自主权，在州和大都市地区都有规划程序。本研究的目的是研究1996年至2000年期间此类资金的分配趋势，这是有有效的抗逆转录病毒药物可用于治疗艾滋病毒的头五年。该研究还考虑了这些趋势是否适应了不断变化的护理模式以及不断变化的艾滋病毒感染者群体的服务需求。
