Performance Improvement 2001. Comparison of Services Received and Health Outcomes for Persons Funded by the CARE Act and by Other Sources


The purpose of this study was to compare demographic characteristics, services needed and provided, and health outcomes between persons receiving CARE Act-funded services and the general treatment population. This study also reports on the clinical characteristics of patients attending a single practice which receives substantial support through Ryan White and assessed if there are differences in clinical outcomes based on payor status. Specifically, the report looks at the Johns Hopkins University AIDS Service (JHUAS), a large, urban, hospital-based clinical practice that has received funding through the Ryan White CARE Act to deliver HIV primary care and subspecialty services since 1990. The study tested these two hypotheses: 1) There are no differences in access to clinical services based on payor status, in particular, receipt of guidelines-recommended highly active combination antiretroviral therapy (HAART). 2) There are no differences in clinical outcomes based on payor status. In 1990, a clinical database was established within the JHUAS designed to capture comprehensive longitudinal data on patients attending this clinical practice. Payor status is assessed through the institution's visit registration database, which captures the method of payment for each completed visit. The results show some resource utilization differences and some differences in receipt of antiretroviral therapies based on payor status. However, in multivariate analysis, there were no differences in development of AIDS and survival among payor types.


FEDERAL CONTACT: Richard Conviser, 301-443-3075

PIC ID: 7123

PERFORMER: Johns Hopkins Medical Institutions, Baltimore, MD