Case management and health-related quality of life outcomes in a national sample of persons with HIV/AIDS.
OBJECTIVE
To examine whether having a case manager is associated with better physical and mental health scores.


BACKGROUND
HIV/AIDS is a condition characterized by a variety of medical and social needs that vary between individuals and over time. Case management has been advocated as a means to improve problems of access, cost and outcomes of HIV/AIDS care.


METHODS
We analyzed data from a nationally representative sample of 2,251 HIV-positive persons receiving care in the in the HIV Costs and Services Utilization Study (HCSUS). Participants were interviewed at baseline and approximately 18 months later. Data were collected on use of case management, sociodemographics, antiretroviral therapy and health-related quality of life. We examined bivariate and multivariate associations of case management at baseline with change in self-reported physical health and mental health at follow-up.


RESULTS
We found that having contact with a case manager at baseline significantly predicted improvement in physical health (regression coefficient=1.02, p<0.05) among those not receiving HAART. We found no association of case management with mental health among those not receiving HAART and those receiving HAART in multivariate analysis.


CONCLUSIONS
Our findings support a beneficial relationship between case managers and physical health for patients with HIV but only among those not already receiving recommended treatment with HAART.
Cunningham
William E
WE
Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA, Los Angeles, California 90095, USA. wcunningham@mednet.ucla.edu
Wong
Mitch
M
Hays
Ron D
RD
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D019090:Case Management; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D016896:Treatment Outcome