Retention of clients in service under two models of home health care for HIV/AIDS.
OBJECTIVE
To determine if a Transprofessional, care-management approach (experimental group) produces different patterns of retention in home treatment as compared to a Traditional treatment approach (control group). The care-management approach utilizes an interdisciplinary mix of allied health professionals who adhere to a service delivery protocol based on active medical, surgical treatment (curative services) as well as on pain, symptoms, and emotional care (palliative services). Initially, the Transprofessional Model should lead to a greater retention rate in the program as patients bond to blended care managers, but in later stages clients needing hospice should be moved off-services resulting in lower retention rates in the medical-surgical home care venue.


METHODS
Data were collected from 549 AIDS patients admitted for medical/surgical home-care services to the Visiting Nurse Association of Los Angeles (VNA-LA). Demographic and disease-specific data were collected from admitting records; service-utilization data were collected from the VNA-LA's computerized data system.


METHODS
Upon admission for home-care services, patients were randomly assigned to an experimental (Transprofessional) or control (Traditional) treatment group. Service levels were comparable. PRIMARY FINDING: In the earliest stages, Transprofessional patients tend to be more likely to stay in treatment, probably due to the greater bonding to the program. After about one year, the Transprofessional patients are more likely to leave the program as they are transitioned into hospice care.


CONCLUSIONS
An integrated model of service delivery, which is based on interdisciplinary care-management and blended modalities of service, provides a quality of life enhancing and a cost-effective method in the provision of home-care services for terminally ill AIDS patients.
Huba
G J
GJ
Measurement Group, Culver City, CA 90230, USA. ghuba@themeasurementgroup.com
Cherin
D A
DA
Melchior
L A
LA
D003266:Continuity of Patient Care / Q000191:economics / Q000458:organization & administration / Q000592:standards; D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000451:nursing*; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007902:Length of Stay; D015141:Los Angeles; D008297:Male; D017146:Models, Organizational; D009936:Organizational Innovation; D016019:Survival Analysis