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Abstract
Organization of care and health setting for people living with HIV/AIDS: a Cochrane systematic review
C. Handford1, A.-M. Tynan2, J. Rackal3, R.H. Glazier4
Background: Treating the world’s 40.3 million persons currently infected with HIV/AIDS is an international responsibility. Certain models of organization of care have proven effective for patients living with a variety of chronic illnesses but their application to HIV/AIDS is less well understood. Our objective was to perform a systematic review, using Cochrane Collaboration methods, to evaluate the association between the organization of care and outcomes for people living with HIV/AIDS.
Methods: We searched MEDLINE, EMBASE, Dissertation Abstracts International (DAI), CINAHL, HealthStar, PsychInfo, PsychLit, Social Sciences Abstracts, and Sociological Abstracts from January 1, 1980 through December 31, 2002 as well as meeting abstracts and relevant journals. The presented review will be updated to December 2005. We selected controlled observational and experimental studies of adults and/or children currently infected with HIV/AIDS that examined the impact of the organization and/or setting of care on outcomes of mortality, opportunistic infections, use of HAART and prophylaxis, quality of life, healthcare utilization, and costs for patients with HIV/AIDS. All languages were included. Study selection and data abstraction were performed by two independent reviewers.
Results: We reviewed 11,266 titles, and 1322 abstracts, and identified 26 predominantly observational studies for inclusion. The studies indicate that case management strategies and higher hospital and ward volume of HIV-positive patients are associated with decreased mortality. Case management is also associated with increased receipt of ARVs. Results for multidisciplinary teams or multi-faceted treatment were more mixed. No studies looked at quality of life or immunological/virological outcomes. Healthcare utilization outcomes were mixed.
Conclusions: Certain organization of care models (i.e. case management) and settings of healthcare (i.e. high volume of HIV-positive patients) may improve patient mortality and other outcomes. More detailed descriptions of care models, consistent definition of terms, and studies on innovative models suitable for developing country settings are needed.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
TUPE0218
Suggested Citation
"C.Handford, et al.
Organization of care and health setting for people living with HIV/AIDS: a Cochrane systematic review.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
TUPE0218"
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