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Determinants of HIV Outpatient Service Utilization: A Systematic Review

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Abstract

Demands on HIV services are increasing as a consequence of the increased life-expectancy of HIV patients in the highly active antiretroviral therapy era. Understanding the factors that influence utilization of ambulatory HIV services is useful for planning service provision. This study reviewed factors associated with utilization of hospital based HIV out-patient services. Studies reporting person-based utilization rates of HIV-specific outpatient services broken down by patient or healthcare characteristics were eligible for inclusion. The Andersen Behavioral Model was used to organize the information extracted into pre-disposing, enabling and need components. Ten studies were included in the final review. Older age, private insurance, urban residence, lower CD4 counts, a diagnosis of AIDS, or anti-retroviral treatment were associated with higher utilization rates. The results of this review are consistent with existing knowledge regarding HIV patients’ use of health services. Little information was identified on the influence of health service characteristics on utilization of out-patient services.

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References

  1. van Sighem AI, Gras LA, Reiss P, Brinkman K, de Wolf F. Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals. AIDS (London, England). 2010;24:1527–35.

    Article  Google Scholar 

  2. Nakagawa F, Lodwick RK, Smith CJ, et al. Projected life expectancy of people with HIV according to timing of diagnosis. AIDS (London, England). 2012;26:335–43.

    Article  Google Scholar 

  3. Giordano TP, Gifford AL, White AC, et al. Retention in care: a challenge to survival with HIV infection. Clin Infect Dis. 2007;44:1493–9.

    Article  PubMed  Google Scholar 

  4. Asboe D, Aitken C, Boffito M, et al (2011) British HIV association guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals. BHIVA.

  5. European AIDS Clinical Society. Guidelines version. 2011;6:2011.

    Google Scholar 

  6. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-Infected adults and adolescents. Department of Health and Human Services. 2012.

  7. Sayana S, Javanbakht M, Weinstein M, Khanlou H. Clinical impact and cost of laboratory monitoring need review even in resource-rich setting. J AIDS J Acquir Immune Defic Syndr. 2011;56(3):e97–8. doi:10.1097/QAI.1090b1013e31820472e31820478.

    Article  Google Scholar 

  8. Buclin T, Telenti A, Perera R, et al. Development and validation of decision rules to guide frequency of monitoring CD4 cell count in HIV-1 infection before starting antiretroviral therapy. PLoS One. 2011;6(4):e18578.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Health Resources and Services Administration. HIV AIDS Bureau Performance Measures. http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html (2013). Accessed 18 March 2014.

  10. Andersen RM. A behavioral model of families’ use of health services. Research Series No. 25. Center for Health Administration Studies, University of Chicago. 1968.

  11. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.

    Article  CAS  PubMed  Google Scholar 

  12. Babitsch B, Gohl D, von Lengerke T. Re-revisiting Andersen’s behavioral model of health services use: a systematic review of studies from 1998–2011. Psycho-soc Med. 2012;9:Doc11.

    Google Scholar 

  13. Treanor C, Donnelly M. An international review of the patterns and determinants of health service utilisation by adult cancer survivors. BMC Health Serv Res. 2012;12:316.

    Article  PubMed Central  PubMed  Google Scholar 

  14. McCusker J, Karp I, Cardin S, Durand P, Morin J. Determinants of emergency department visits by older adults: a systematic review. Acad Emerg Med. 2003;10(12):1362–70.

    Article  PubMed  Google Scholar 

  15. deBoer A, Wijker W, deHaes H. Predictors of health care utilization in the chronically ill: a review of the literature. Health Policy. 1997;42(2):101–15.

    Article  CAS  Google Scholar 

  16. Uphold CR, Mkanta WN. Review: use of health care services among persons living with HIV infection: state of the science and future directions. AIDS Patient Care STDS. 2005;19(8):473–85.

    Article  PubMed  Google Scholar 

  17. Marks G, Gardner LI, Craw J, Crepaz N. Entry and retention in medical care among HIV-diagnosed persons: a meta-analysis. AIDS (London, England). 2010;24:2665–78.

    Article  Google Scholar 

  18. Beck EJ, Harling G, Gerbase S, DeLay P. The cost of treatment and care for people living with HIV infection: implications of published studies, 1999–2008. Curr Opin HIV AIDS. 2010;5(3):215–24.

    Article  PubMed  Google Scholar 

  19. Car LT, Brusamento S, Elmoniry H, et al. The uptake of integrated perinatal prevention of mother-to-child HIV transmission programs in low- and middle-income countries: a systematic review. PLoS One. 2013;8(3):e56550.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Centre for Reviews and Dissemination. Systematic reviews CRDs guidance for undertaking reviews in healthcare. York: CRD University of York; 2009.

    Google Scholar 

  21. The Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions version 5.1.0 (updated March 2011): The Cochrane Collaboration; 2011.

  22. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Gelberg L, Andersen RM, Leake BD. The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv Res. 2000;34(6):1273–302.

    CAS  PubMed Central  PubMed  Google Scholar 

  24. Fleishman JA, Gebo KA, Reilly ED, et al. Hospital and outpatient health services utilization among HIV-infected adults in care 2000–2002. Med Care. 2005;43(9):III40–52.

    PubMed  Google Scholar 

  25. Siddiqui J, Phillips AL, Freedland ES, Sklar AR, Darkow T, Harley CR. Prevalence and cost of HIV-associated weight loss in a managed care population. Curr Med Res Opin. 2009;25(5):1307–17.

    Article  PubMed  Google Scholar 

  26. Wilson LE, Korthuis T, Fleishman JA, et al. HIV-related medical service use by rural/urban residents: a multistate perspective. AIDS Care. 2011;23(8):971–9.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Howe CJ, Cole SR, Napravnik S, Eron JJ. Enrollment, retention, and visit attendance in the University of North Carolina Center for AIDS Research HIV clinical cohort, 2001–2007. AIDS Res Hum Retroviruses. 2010;26(8):875–81.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Velasco M, Castilla V, Guijarro C, Moreno L, Barba R, Losa JE. Differences in the use of health resources by Spanish and immigrant HIV-infected patients. Enferm Infecc Microbiol Clin. 2012;30(8):458–62.

    Article  PubMed  Google Scholar 

  29. Garattini L, Tediosi F, Di Cintio E, Yin D, Parazzini F. Resource utilization and hospital cost of HIV/AIDS care in Italy in the era of highly active antiretroviral therapy. AIDS Care. 2001;13(6):733–41.

    Article  CAS  PubMed  Google Scholar 

  30. Cook PA, Downing J, Wheater CP, et al. Influence of socio-demographic factors on distances travelled to access HIV services: enhanced surveillance of HIV patients in North West England. BMC Public Health. 2009;9:78.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Bikilla AD, Jerene D, Robberstad B, Lindtjorn B. Cost estimates of HIV care and treatment with and without anti-retroviral therapy at Arba Minch Hospital in southern Ethiopia. Cost Eff Resour Alloc. 2009;7:6.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Larson BA, Bii M, Henly-Thomas S, et al. ART treatment costs and retention in care in Kenya: a cohort study in three rural outpatient clinics. J Int AIDS Soc. 2013;16(1):18026.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Paton NI, Chapman CAT, Sangeetha S, Mandalia S, Bellamy R, Beck EJ. Cost and cost-effectiveness of antiretroviral therapy for HIV infection in Singapore. Int J STD AIDS. 2006;17(10):699–705.

    Article  PubMed  Google Scholar 

  34. Motheral B, Brooks J, Clark MA, et al. A checklist for retrospective database studies—report of the ISPOR task force on retrospective databases. Value Health. 2003;6(2):90–7.

    Article  PubMed  Google Scholar 

  35. HIV Research Network. https://cds.johnshopkins.edu/hivrn/index.cfm. Accessed 24 Sept 2013.

  36. Horstmann E, Brown J, Islam F, Buck J, Agins BD. Retaining HIV-infected patients in care: where are we? Where do we go from here? Clin Infect Dis. 2010;50(5):752–61.

    PubMed  Google Scholar 

  37. Fleishman JA, Yehia BR, Moore RD, Korthuis PT, Gebo KA, Network HR. Establishment, retention, and loss to follow-up in outpatient HIV care. J Acquir Immune Defic Syndr. 2012;60:249–59.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Goulet JL, Fultz SL, Rimland D, et al. Aging and infectious diseases: do patterns of comorbidity vary by HIV status, age, and HIV severity? Clin Infect Dis. 2007;45(12):1593–601.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Hasse B, Ledergerber B, Furrer H, et al. Morbidity and aging in HIV-infected persons: the Swiss HIV Cohort Study. Clin Infect Dis. 2011;53:1130–9.

    Article  PubMed  Google Scholar 

  40. National Association of People Living with HIV, National Centre in HIV Epidemiology and Clinical Research. Mapping HIV outcomes: geographical and clinical forecasts of numbers of people living with HIV in Australia. The University of New South Wales. 2011.

  41. Deeken JF, Tjen ALA, Rudek MA, et al. The rising challenge of non-AIDS-defining cancers in HIV-infected patients. Clin Infect Dis. 2012;55(9):1228–35.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Triant VA. HIV infection and coronary heart disease: an intersection of epidemics. J Infect Dis. 2012;205(Suppl 3):S355–61.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  43. Miro JM, Cofan F, Trullas JC, et al. Renal dysfunction in the setting of HIV/AIDS. Curr HIV/AIDS Rep. 2012;9(3):187–99.

    Article  PubMed  Google Scholar 

  44. Norman SP, Kommareddi M, Kaul DR. Update on kidney transplantation in HIV-infected recipients. AIDS Rev. 2012;14(3):195–207.

    PubMed  Google Scholar 

  45. Joshi D, O’Grady J, Taylor C, Heaton N, Agarwal K. Liver transplantation in human immunodeficiency virus-positive patients. Liver Transpl. 2011;17(8):881–90.

    Article  PubMed  Google Scholar 

  46. Kearney F, Moore AR, Donegan CF, Lambert J. The ageing of HIV: implications for geriatric medicine. Age Ageing. 2010;39(5):536–41.

    Article  PubMed  Google Scholar 

  47. Abraham JM. How might the affordable care act’s coverage expansion provisions influence demand for medical care? Milbank Q. 2014;92(1):63–87.

    Article  PubMed  Google Scholar 

  48. United Nations Department of Economic and Social Affairs Population Division. World urbanization prospects, the 2011 revision. http://esa.un.org/unpd/wup/index.htm (2011). Accessed 27 March 2014.

  49. Mandalia S, Mandalia R, Lo G, et al. Rising population cost for treating people living with HIV in the UK, 1997–2013. PLoS One. 2010;5(12):e15677.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Stover J, Korenromp EL, Blakley M, et al. Long-term costs and health impact of continued global fund support for antiretroviral therapy. PLoS One. 2011;6(6):e21048.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

AB is a Health Research Board PhD Scholar and this work was funded by the Health Research Board in Ireland under Grant No. PHD/2007/16.

Conflict of interest

None of the authors have any relevant conflict of interest for this study.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, University College Cork, Cork, Ireland

    Aline Brennan

  2. Cork University Hospital, Cork, Ireland

    Deirdre Morley & Mary Horgan

  3. St James’s Hospital, Dublin and Royal College of Surgeons, Dublin, Ireland

    Aisling C. O’Leary

  4. St James’s Hospital, Dublin and Trinity College Dublin, Dublin, Ireland

    Colm J. Bergin

  5. School of Medicine, University College Cork, Cork, Ireland

    Mary Horgan

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  1. Aline Brennan
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  2. Deirdre Morley
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  3. Aisling C. O’Leary
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  4. Colm J. Bergin
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Correspondence to Aline Brennan.

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Brennan, A., Morley, D., O’Leary, A.C. et al. Determinants of HIV Outpatient Service Utilization: A Systematic Review. AIDS Behav 19, 104–119 (2015). https://doi.org/10.1007/s10461-014-0814-z

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  • DOI: https://doi.org/10.1007/s10461-014-0814-z

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