Development and application of a new measure of engagement in out‐patient HIV care
نویسندگان
چکیده
OBJECTIVES Commonly used measures of engagement in HIV care do not take into account that the frequency of attendance is related to changes in treatment and health status. This study developed a new measure of engagement in care (EIC) incorporating clinical factors. METHODS We conducted semi-structured interviews with eight HIV physicians to identify factors associated with the timing of patients' next scheduled appointments. These factors informed the development of an algorithm to classify each month of follow-up as "in care" (on or before the time of the next expected attendance) or "out of care" (after the time of the next expected attendance). The EIC algorithm was applied to data from the UK Collaborative HIV Cohort (UK CHIC) study, a large clinical cohort study. RESULTS The interviews indicated that time to next appointment varied depending on psychosocial and physical comorbidities, and clinical factors (time since diagnosis, AIDS diagnosis, treatment status, CD4 count and viral load). The resulting EIC algorithm was applied to 44 432 patients; 83.9% of the 3 021 224 person-months were "in care". Greater EIC was independently associated with older age, white ethnicity, HIV acquisition through sex between men, current use of antiretroviral therapy (ART), a higher nadir CD4 count, later calendar year and being seen at the clinic for the first time within the last year. CONCLUSIONS This algorithm describing engagement in HIV care incorporates a time-updated measure of patients' treatment and health status. It adds to the options available for measuring this key performance indicator.
منابع مشابه
Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes
Background Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research ...
متن کاملتحلیل مفهوم مشارکت بیمار مبتلا به بیماری مزمن: استفاده از الگوی هیبرید
Background and Aim: Approaches to professional health care have changed along with changes in health measures and progression of chronic diseases. Patient participation is an international golden standard in new nursing paradigm. Despite the importance of patient participation and its routine usage in professional care, this concept is not clear, especially in social and cultural context of I...
متن کاملUsing the Taxonomy and the Metrics: What to Study When and Why; Comment on “Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review”
Dukhanin and colleagues’ taxonomy of metrics for patient engagement at the organizational and system levels has great potential for supporting more careful and useful evaluations of this ever-growing phenomenon. This commentary highlights the central importance to the taxonomy of metrics assessing the extent of meaningful participation in decision-making by patients, consumers and community mem...
متن کاملBreaking Gridlock in Health Policy?; Comment on “A New Synthesis”
Pierre-Gerlier Forest has put forward the case that we are on the brink of a revolution in health policy that will be the result of the interplay of five factors. I would not challenge any of them but would emphasize the need to address socio-economic health inequalities, which have the potential to become a major cost driver in a time of growing economic inequality. To Dr. Forest’s list, I wou...
متن کاملMetrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review
Background Patient, public, consumer, and community (P2C2) engagement in organization-, community-, and systemlevel healthcare decision-making is increasing globally, but its formal evaluation remains challenging. To define a taxonomy of possible P2C2 engagement metrics and compare existing evaluation tools against this taxonomy, we conducted a systematic review. Methods A broad search strate...
متن کاملPatient Engagement and its Evaluation Tools – Current Challenges and Future Directions; Comment on “Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review”
Considering the growing recognition of the importance of patient engagement in healthcare decisions, research and delivery systems, it is important to ensure high quality and efficient patient engagement evaluation tools. In this commentary, we will first highlight the definition and importance of patient engagement. Then we discuss the psychometric properties of the patient engagement evaluati...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 18 شماره
صفحات -
تاریخ انتشار 2017