Evaluating patterns in retention, continuation, gaps, and re-engagement in HIV care in a Medicaid-insured population, 2006–2012, United States

Details

• Alternative Title:
  AIDS Care
• Personal Author:
  Byrd, Kathy K. ; Furtado, Melissa ; Bush, Tim ; Gardner, Lytt
• Description:
  We used the US-based MarketScan(®) Medicaid Multi-state Databases to determine the un-weighted proportion of publically insured persons with HIV that were retained, continued, and re-engaged in care. Persons were followed for up to 84 months. Cox proportional hazards models were conducted to determine factors associated with gaps in care. Of the 6463 HIV cases identified in 2006, 61% were retained during the first 24 months, and 53% continued in care through 78 months. Between 8% and 30% experienced a gap in care, and 59% of persons who experienced a gap in care later re-engaged in care. Persons with one or more Charlson co-morbidities (HR 0.72, 95% CI 0.64-0.81), ages 40-59 (0.79, 0.71-0.88), mental illness diagnosis (0.79, 0.72-0.87), hepatitis C co-infection (0.83, 0.75-0.93), and female sex (0.86, 0.78-0.94) were less likely to experience a gap in care. Between 27% and 38% of those not retained in care continued to receive HIV-related laboratory services. This Medicaid claims database combines features of both clinic visits-based and surveillance lab-based surrogate measures to give a more complete picture of engagement in care than single-facility-based studies.
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Ambulatory Care Anti-Retroviral Agents Article Comorbidity Continuity Of Patient Care Engagement In Care Female Gap In Care Health Behavior Health Care Surveys Health Services Health Services Needs And Demand Hepatitis C HIV HIV Infections Humans Insurance Claim Review Lost To Follow-Up Male Medicaid Medication Adherence Mental Disorders Middle Aged Proportional Hazards Models Retention In Care Young Adult

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• Source:
  AIDS Care. 27(11):1387-1395.
• Pubmed ID:
  26679267
• Pubmed Central ID:
  PMC6195763
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  27
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e5b555fcf39f990b8c3a0ec0b0f5434c73171fdaa81c460ad28cb39be16342ba
• Download URL:
  https://stacks.cdc.gov/view/cdc/59840/cdc_59840_DS1.pdf
• File Type:
  [PDF - 762.34 KB ]