[Evaluation of the organizational structure of HIV/AIDS outpatient care in Brazil].
OBJECTIVE
In the context of universal access to antiretroviral treatment, the results of the Brazilian AIDS Program will depend on the quality of the care provided. The aim of the present study was to evaluate the healthcare provided by outpatient services for the treatment of AIDS patients.


METHODS
The present study was carried out in seven Brazilian States between 2001 and 2002. We evaluated the quality of the care provided to AIDS patients from the standpoint of resource availability and care process organization. A questionnaire comprising 112 structured questions addressing these aspects was sent to 336 services.


RESULTS
Response rate was 95.8% (322). Greater adequacy is seen for indicators of resource availability than for those of work organization. The supply of antiretroviral medication is sufficient in 95.5% of services. CD4 and viral load tests are available at adequate amounts in 59 and 41% of services, respectively. In 90.4% of services there is at least one non-medical professional (psychologist, nurse, or social worker). As to work organization, 80% scheduled the date but not the time of medical appointments; 40.4% scheduled more than 10 appointments per period; 17% did not have exclusive managers; and 68.6% did not hold systematic staff meetings.


CONCLUSIONS
The results indicate that, in addition to ensuring the more homogeneous distribution of resources, the program must invest in the training and dissemination of care management skills, as confirmed by the results of care process organization.
Melchior
Regina
R
Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, PR, Brazil. reginamelchior@sercomtel.com.br
Nemes
Maria Ines Battistella
MI
Basso
Cáritas Relva
CR
Castanheira
Elen Rose Lodeiro
ER
Alves
Maria Teresa Soares de Britto e
MT
Buchalla
Cássia Maria
CM
Donini
Angela Aparecida
AA
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000553:Ambulatory Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D001938:Brazil; D003695:Delivery of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D019562:Viral Load