Sitapati Amy M, Limneos Jan, Bonet-Vázquez Militza, Mar-Tang Moira, Qin Huifang, Mathews W Christopher
Owen Clinic and Department of Medicine at University of San Diego, California, USA.
J Health Care Poor Underserved. 2012 Aug;23(3 Suppl):81-95. doi: 10.1353/hpu.2012.0139.
Here, we describe our patient-centered medical home (PCMH) quality improvement retention project conducted by a Health Resources and Services Administration (HRSA) Ryan White-funded Primary Care HIV clinic. The single urban academic clinic serving 2,776 active HIV positive patients identified 25.8% (716/2,776) patients who had not been retained in care within the prior six months during two separate six-month interval analyses. Multiple modalities including a retention specialist, a secure clinic phone message line, algorithms, flyers, brochures, database, and staff education were built to facilitate re-engagement. The project located 87.7% (628/716) patients who had not been retained. The retention specialist was directly responsible for the return of 16.2% (116/716) patients. Results from the project demonstrated that a formalized approach is a necessary component to effective retention efforts. We believe that this work will provide a strategic framework for the development of randomized control trials to formally evaluate an HIV retention intervention.
在此，我们描述了一项以患者为中心的医疗之家（PCMH）质量改进留存项目，该项目由美国卫生资源与服务管理局（HRSA）瑞安·怀特基金资助的一家初级保健HIV诊所开展。这家位于城市的学术诊所为2776名活跃的HIV阳性患者提供服务，在两次单独的为期六个月的间隔分析中，确定有25.8%（716/2776）的患者在过去六个月内未持续接受治疗。通过多种方式促进重新参与，包括设立一名留存专员、一条安全的诊所电话留言热线、算法、传单、手册、数据库以及员工培训。该项目找到了87.7%（628/716）未持续接受治疗的患者。留存专员直接促使16.2%（116/716）的患者回归治疗。该项目的结果表明，一种规范化的方法是有效留存工作的必要组成部分。我们相信，这项工作将为开展随机对照试验以正式评估HIV留存干预措施提供一个战略框架。
