title: Health administrative data can be used to define a shared care typology for people with HIV.
abstract: OBJECTIVE
  Building on an existing theoretical shared primary care/specialist care framework to (1) develop a unique typology of care for people living with human immunodeficiency virus (HIV) in Ontario, (2) assess sensitivity of the typology by varying typology definitions, and (3) describe characteristics of typology categories.
  
  
  METHODS
  Retrospective population-based observational study from April 1, 2009, to March 31, 2012. A total of 13,480 eligible patients with HIV and receiving publicly funded health care in Ontario. We derived a typology of care by linking patients to usual family physicians and to HIV specialists with five possible patterns of care. Patient and physician characteristics and outpatient visits for HIV-related and non-HIV-related care were used to assess the robustness and characteristics of the typology.
  
  
  RESULTS
  Five possible patterns of care were described as low engagement (8.6%), exclusively primary care (52.7%), family physician-dominated comanagement (10.0%), specialist-dominated comanagement (30.5%), and exclusively specialist care (5.2%). Sensitivity analyses demonstrated robustness of typology assignments. Visit patterns varied in ways that conform to typology assignments.
  
  
  CONCLUSIONS
  We anticipate this typology can be used to assess the impact of care patterns on the quality of primary care for people living with HIV.
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère St, RM 337Y, Ottawa, Ontario, Canada K1N 5C8; Department of Family Medicine, University of Ottawa, 43 Bruyère St, Floor 3JB, Ottawa, Ontario, Canada K1N 5C8. Electronic address: ckendall@uottawa.ca.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Kendall
authors.affiliation: Institute for Clinical Evaluative Sciences (uOttawa), 1053 Carling Ave., Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, 725 Parkdale Ave., Ottawa, Ontario, Canada.
authors.forename: Jaime
authors.initials: J
authors.lastname: Younger
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère St, RM 337Y, Ottawa, Ontario, Canada K1N 5C8; Department of Family Medicine, University of Ottawa, 43 Bruyère St, Floor 3JB, Ottawa, Ontario, Canada K1N 5C8; Ottawa Hospital Research Institute, 725 Parkdale Ave., Ottawa, Ontario, Canada.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Manuel
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère St, RM 337Y, Ottawa, Ontario, Canada K1N 5C8; Department of Family Medicine, University of Ottawa, 43 Bruyère St, Floor 3JB, Ottawa, Ontario, Canada K1N 5C8.
authors.forename: William
authors.initials: W
authors.lastname: Hogg
authors.affiliation: Institute for Clinical Evaluative Sciences, 2075 Bayview Ave., Room G1-06, Toronto, Ontario, Canada M4N 3M5; Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, Canada M5B 1W8; Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, Canada M5B 1W8; Department of Family and Community Medicine, University of Toronto, 500 University Ave., 5th Floor, Toronto, Ontario, Canada M5G 1V7.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Glazier
authors.affiliation: Ottawa Hospital Research Institute, Clinical Epidemiology Program, 1053 Carling Ave., Ottawa, Ontario, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Rd., Room 3105, Ottawa, Ontario, Canada K1H 8M5.
authors.forename: Monica
authors.initials: M
authors.lastname: Taljaard
mesh_terms: D000067575:Administrative Claims, Healthcare; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010348:Patient Care Team / Q000145:classification*; D011320:Primary Health Care; D012189:Retrospective Studies
keywords: Chronic disease; Comorbidity; HIV/AIDS; Health services delivery; Human immunodeficiency virus; Integrated care; Primary health care; Shared care