title: Methods to Obtain a Representative Sample of Ryan White-Funded Patients for a Needs Assessment in Los Angeles County: Results from a Replicable Approach.
abstract: The Health Resources and Services Administration requires that jurisdictions receiving Ryan White (RW) funding justify need, set priorities, and provide allocations using evidence-based methods. Methods and results from the 2011 Los Angeles Coordinated HIV/AIDS Needs Assessment-Care (LACHNA-Care) study are presented. Individual-level weights were applied to expand the sample from 400 to 18 912 persons, consistent with the 19 915 clients in the system. Awareness, need, and utilization for medical outpatient care were high (>90%). Other services (eg, child care) had limited awareness (21%). Majority of participants reported at least 1 service gap (81%). Lack of insurance (risk ratio [RR] = 3.0, 95% confidence interval [CI]: 1.5-6.2), substance use (RR = 2.9, 95% CI: 1.3-6.4), and past lapses in medical care (RR = 2.8, 95% CI: 1.3-5.9) were associated with gaps. Within clusters, past incarceration was associated with gaps for housing (RR = 13.5, 95% CI: 3.5-52.1), transportation (RR = 3.2, 95% CI: 1.2-8.4), and case management (RR = 4.0, 95% CI: 1.3-12.2). Applied methods resulted in representative data instrumental to RW program planning efforts.
authors.affiliation: 1 Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
authors.forename: Rhodri
authors.initials: R
authors.lastname: Dierst-Davies
authors.affiliation: 1 Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
authors.forename: Amy Rock
authors.initials: AR
authors.lastname: Wohl
authors.affiliation: 2 Los Angeles County Commission on HIV, Los Angeles, CA, USA.
authors.forename: Glenda
authors.initials: G
authors.lastname: Pinney
authors.affiliation: 3 U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Johnson
authors.affiliation: 2 Los Angeles County Commission on HIV, Los Angeles, CA, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Vincent-Jones
authors.affiliation: 1 Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Pérez
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D019090:Case Management / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D003752:Dental Health Services / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000191:economics / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D017051:Hospice Care / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D020380:Needs Assessment; D012107:Research Design; D012494:Sampling Studies; D012947:Social Work / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D014186:Transportation / Q000706:statistics & numerical data; D055815:Young Adult
keywords: HIV; Ryan White; needs assessment; patient care; service gaps