486. Characterizing Outpatient Utilization Patterns and Identifying Predictors of Engagement in Care for Persons with HIV
Session: Poster Abstract Session: HIV Primary Care
Friday, October 21, 2011
Room: Poster Hall B1
  • IDSA engagement retention abstract_10_14_11.pdf (3.1 MB)
  • Background: Engaging HIV-infected patients in regular medical care is essential. Unfortunately, less than 60% of HIV patients participate in recommended outpatient (OP) care. This study describes OP care use over time and identifies factors associated with engagement in care.

    Methods: We examined 20,274 HIV-infected adults at 12 US HIV clinics who enrolled in care from 2000-08. OP care use was determined by: (1) length of engagement in care (all OP visits occurring within 2 months (brief engagers) vs. having OP visits ≥ 2 months (sustained engagers)) and (2) presence or absence of a break in care (> 6 months between OP visits). Logistic regression examined factors associated with brief engagement (vs. sustained) and breaks in care (vs. no breaks among sustained engagers).

    Results: 2,457 (12%) patients were brief engagers, of whom 45% had only 1 OP visit. Among sustained engagers, 9,262 of 17,817 (52%) had one or more breaks in care. Younger patients (age 18-29), men, those with injection-drug-use-related HIV transmission (versus heterosexual), and non-Hispanic patients were more likely to be brief engagers. Younger patients, Blacks, and those with higher CD4 counts at their first OP visit were more likely to have a break in care.

    Conclusion: A significant number of HIV patients do not consistently engage in outpatient care. Younger patients and those with initially high CD4 counts were particularly likely to briefly engage or to interrupt care.  These findings point to groups that may require special efforts to promote optimal use of HIV care.


    Subject Category: H. HIV/AIDS and other retroviruses

    Baligh R. Yehia, MD1, John A. Fleishman, PhD2, Joshua Metlay, MD PhD1 and Kelly Gebo, MD, MPH3, (1)University of Pennsylvania School of Medicine, Philadelphia, PA, (2)Agency for Healthcare Research and Quality, Rockville, MD, (3)John Hopkins University School of Medicine, Baltimore, MD


    B. R. Yehia, None

    J. A. Fleishman, None

    J. Metlay, None

    K. Gebo, None

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