University of Michigan, Ann Arbor, MI, USA.
School of Social Work, University of Michigan, 1080 S University Ave, Ann Arbor, MI, 48109, USA.
AIDS Behav. 2019 Sep;23(9):2542-2548. doi: 10.1007/s10461-019-02508-6.
Missing 3 + scheduled HIV primary care visits over a 1-year period increases mortality risk for people living with HIV (PLWH). We used electronic health data from PLWH (≥ 18 years old) at a southeastern US HIV clinic in 2016 to examine differences across patient-level characteristics and number of missed visits (1-2 vs. 0, 3 + vs. 0, 3 + vs. 1-2). In multivariable multinomial logistic regression analyses, poverty, lack of Ryan White HIV/AIDS Program support services, being uninsured, not having a high school degree, and being younger were significantly associated with 1-2 or 3 + missed visits (vs. 0 missed). Only poverty remained predictive of missing 3 + versus 1-2 visits (RR = 2.70, 95% CI 1.49-4.88). Patients at risk for missing 3 + visits present similar characteristics to patients who miss 1-2 visits. Interventions aimed at poverty reduction and increased access to education, health insurance, and support services may improve retention and, therefore, decrease mortality risk.
在一年的时间内错过 3 次及以上预约的 HIV 初级保健就诊会增加 HIV 感染者（PLWH）的死亡风险。我们使用了 2016 年美国东南部一家 HIV 诊所的 PLWH（≥18 岁）的电子健康数据，以检查患者特征和错过就诊次数（1-2 次比 0 次、3 次及以上比 0 次、3 次及以上比 1-2 次）之间的差异。在多变量多项逻辑回归分析中，贫困、缺乏 Ryan White HIV/AIDS 计划支持服务、没有医疗保险、没有高中学历以及年龄较小与 1-2 次或 3 次及以上错过就诊（与 0 次错过就诊相比）显著相关。只有贫困与错过 3 次及以上就诊相比仍然具有预测性（RR=2.70，95%CI 1.49-4.88）。有错过 3 次及以上就诊风险的患者与错过 1-2 次就诊的患者具有相似的特征。旨在减少贫困和增加获得教育、医疗保险和支持服务机会的干预措施可能会提高保留率，从而降低死亡率风险。
