title: Determinants of HIV outpatient service utilization: a systematic review.
abstract: Demands on HIV services are increasing as a consequence of the increased life-expectancy of HIV patients in the highly active antiretroviral therapy era. Understanding the factors that influence utilization of ambulatory HIV services is useful for planning service provision. This study reviewed factors associated with utilization of hospital based HIV out-patient services. Studies reporting person-based utilization rates of HIV-specific outpatient services broken down by patient or healthcare characteristics were eligible for inclusion. The Andersen Behavioral Model was used to organize the information extracted into pre-disposing, enabling and need components. Ten studies were included in the final review. Older age, private insurance, urban residence, lower CD4 counts, a diagnosis of AIDS, or anti-retroviral treatment were associated with higher utilization rates. The results of this review are consistent with existing knowledge regarding HIV patients' use of health services. Little information was identified on the influence of health service characteristics on utilization of out-patient services.
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, Cork, Ireland, aline.brennan@ucc.ie.
authors.forename: Aline
authors.initials: A
authors.lastname: Brennan
authors.forename: Deirdre
authors.initials: D
authors.lastname: Morley
authors.forename: Aisling C
authors.initials: AC
authors.lastname: O'Leary
authors.forename: Colm J
authors.initials: CJ
authors.lastname: Bergin
authors.forename: Mary
authors.initials: M
authors.lastname: Horgan
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*