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Uniform, National Measures Should Define HIV/AIDS Care

Wednesday, August 18, 2010 AIDS/HIV News J E 4
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OAKLAND, Calif., Aug. 17 To improve the quality of HIV care and treatment nationwide, 17 measures such as screening and prevention for infections and monitoring of antiretroviral therapy should be adopted uniformly, according to a work group led by a Kaiser Permanente researcher.

The work group's study results appear in the current issue of Clinical Infectious Diseases.

The study shows how national HIV quality performance measures were developed, approved by national bodies, and are being implemented, said Michael Horberg, MD, MAS, FACP, director of HIV/AIDS for Kaiser Permanente, a research scientist at the Kaiser Permanente Division of Research, and the lead author of the study. Horberg was one of two co-chairs who led the effort and determined the measures to be included and their specifications. Kaiser Permanente is the largest private provider of HIV care in the United States.

The measures assess a wide range of care, including patient retention, screening and prevention for infections, immunization, and initiation and monitoring of antiretroviral therapy. The measures are being pilot tested and have been endorsed by the National Quality Forum, National Committee For Quality Assurance, American Medical Association, the HIV Medical Association, Infectious Disease Society of America, and Health Resources and Service Administration (Health & Human Services). "Taken together, these measures represent the most important aspects of HIV care that impact the greatest number of HIV-infected individuals in the Unites States today," Horberg said.

"HIV disease has become a complex, chronic condition. Measurement of quality of care is an essential component of successful therapy," Horberg added. "And once those measurements are made, it's important that they be used to create quality improvement programs that set and create expectations for a certain level of quality care."

Many of the measures outlined by the work group already are in place at Kaiser Permanente, which is the largest private provider of HIV care in the United States and has a large HIV registry of 17,000+ patients that's enabled Kaiser Permanente to improve its HIV management so that the mortality rate for Kaiser Permanente HIV patients is half the national average.

As noted in the study, the measures do not reflect all aspects of HIV care. Most measures related to pregnancy processes and outcomes are not included. Pediatric measures are similarly not present, although the HRSA's HIV-AIDS Bureau is developing a set of those measures.

Co-authors of the paper include Judith A. Aberg, Department of Medicine, New York University School of Medicine, New York, New York; Laura W. Cheever, Health Resources and Services Administration, HIV/AIDS Bureau, Rockville, Md; Philip Renner, National Committee for Quality Assurance, Washington, D.C.; Eric O'Brien Kaleba, Alliance of Chicago Community Health Services, Chicago; and Steven M. Asch, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA and RAND Corporation.

Funding was provided by the National Committee for Quality Assurance, the Physician Consortium for Performance Improvement of the American Medical Association, the HIV Medicine Association of the Infectious Diseases Society of America, And the Health Resources And Service Administration.

Horberg Recently Appointed to Presidential Advisory Council On HIV/AIDS

Horberg was appointed in February to the Presidential Advisory Council on HIV/AIDS, which provides advice and recommendations to President Obama and Health and Human Services Secretary Kathleen Sebelius to strengthen domestic and global efforts to care for patients with HIV and to prevent the spread of the virus.

About the Kaiser Permanente Division of Research (http://www.dor.kaiser.org/)

The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR's 500-plus staff is working on more than 250 epidemiological and health services research projects.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

SOURCE Kaiser Permanente
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