Many different models have been developed for health care delivery to HIV-infected persons. Nevertheless, limited experience has been accumulated in the development of evaluation activities of the system of care. We report on a quality assessment program implemented at our institution that is coordinating the delivery of care to the whole community of HIV-infected persons living in the Bergamo province. A total of 1599 patients, mostly IV drug users, were included in the study, during 1985-1992. Following three years of testing, we selected a number of demographic and clinical parameters in order to define the studied population and to allow computing of two outcome criteria and three process criteria: evaluating survival, incidence of major opportunistic infections (OIs), length of the follow-up preceding the diagnosis of AIDS, timeliness of initiation of antiretroviral therapy, and rate of hospitalization. Other criteria related to drop-out, quality of life, and patients' satisfaction have been excluded as unwieldy and/or unreliable. The final version of our program is a simple computerized tool incorporated into routine clinical practice, which may prove useful for the longitudinal monitoring of the quality of care, and for the comparison of different systems of care.
AIDS Patient Care – Mary Ann Liebert
Published: Aug 1, 1995