Quality of generalist vs. specialty care for people with HIV on antiretroviral treatment: a prospective cohort study.
OBJECTIVE
To describe health-care use by persons with HIV in an urban area of Switzerland (Zurich). Further, to compare the different health-care settings.


METHODS
A 1-year prospective cohort study recruiting 60 patients at general practices and 60 patients at a specialized university outpatient clinic.


METHODS
Patients and their treating physicians were interviewed or answered questionnaires, respectively, at baseline, month 6 and 12.


RESULTS
During the study period, five patient groups were identified among the 106 enrolled patients, of whom (i) 42% saw a general practitioner exclusively, (ii) 31% were treated at the specialized outpatient clinic, (iii) 8% were in shared care, (iv) 10% changed health-care model, and (v) 9% were lost to follow-up. Baseline demographic, psychosocial and clinical data were similar among patient groups. At study end, the proportion of patients with HIV-1 RNA < 400 copies/mL was 72%, 74%, 88%, 55% among groups (i) to (iv), respectively (ns), and 22% at month 6 among those lost to follow-up. Indicators for quality of care were similarly good among all patient groups.


CONCLUSIONS
A well-working system offers high-quality healthcare to persons living with HIV, where existing teams of specialty and primary health-care professionals efficiently and effectively co-operate.
Page
J
J
Institute of Social and Preventive Medicine, University of Zurich, 8006 Zurich, Switzerland. page@ifspmunizhch
Weber
R
R
Somaini
B
B
Nöstlinger
C
C
Donath
K
K
Jaccard
R
R
D000328:Adult; D005194:Family Practice / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D010348:Patient Care Team / Q000592:standards; D010349:Patient Compliance; D017060:Patient Satisfaction; D011446:Prospective Studies; D011787:Quality of Health Care; D011788:Quality of Life; D013038:Specialization; D013557:Switzerland; D019037:Urban Health Services / Q000592:standards