IMPROVING HEALTH CARE UTILIZATION IN HIV+ DRUG USERS

提高艾滋病毒吸毒者的医疗保健利用率

• 批准号: 6515336
• 负责人: KELLY A GEBO
• 金额: $ 15.55万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-01 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6515336
• 关键词: AIDS; HIV infections; behavioral /social science research tag; clinical research; data collection methodology /evaluation; disease /disorder prevention /control; drug abuse prevention; drug abuse therapy; health behavior; health care referral /consultation; health care service utilization; health economics; health education; health services research tag; hospital utilization; human data; patient care management; patient care planning; statistics /biometry; substance abuse related disorder

Dr. Gebo is a Robert Wood Johnson Clinical Scholar and will be an infectious disease fellow at the Johns Hopkins University (2000-01). She has spent the past two years conducting epidemiologic and health services outcomes research for individuals with HIV, many of whom are drug users. Through this award, Dr. Gebo would like to conduct health services research on the interaction of drug abuse and HIV infection, as a faculty member in Infectious Diseases at Johns Hopkins. She will have the mentorship of Drs. Richard Moore and Neil Powe, experts in HIV epidemiologic and health services research, as well as the collaboration of Drs. Mary McCaul and Barbara Turner, established researchers in drug abuse and HIV health services utilization of drug users. To complement her research, Dr. Gebo will complete courses in the School of Public Health in substance abuse, ethics, and advanced biostatistics and health services research methods. Protease inhibitors were shown to decrease morbidity and mortality in HIV+ patients. In pilot data, Dr. Gebo found that hospitalization rates in our HIV+ patients decreased significantly between 1995 and 1997; however, this trend was markedly attenuated in patients with a history of illicit drug use. Illicit drug use is strongly associated with hospitalization among HIV+ patients, even after adjustment for antiretroviral use. To explore this, Dr. Gebo will perform a cohort study on patients followed in the Johns Hopkins HIV clinic where she will examine hospitalization and outpatient care utilization rates, in a time-series analysis, between 1998 and 2001. She will also conduct a cross-sectional study of patients enrolled in the Johns Hopkins HIV Clinic in 2001 to examine the adequacy of preventive care utilization. After assessing utilization patterns, she will conduct an intervention of intensive case management in substance abusing patients to increase substance abuse treatment and decrease substance use. Finally, she will conduct a cost-effectiveness analysis of the intervention. The goals of the award are to identify areas of over and under utilization of health care by HIV+ patients, and to increase completion of substance abuse treatment referrals and decrease overall substance use in HIV+ drug users. The combination of research utilizing existing data sources, as well as intervention planning and primary data collection, the excellent mentorship of senior scientists, the coursework available, and the supportive environment of the Johns Hopkins University will provide Dr. Gebo the skills she needs to develop into an independent clinician researcher in HIV epidemiologic and health services research.

Gebo 博士是罗伯特伍德约翰逊临床学者，并将成为约翰霍普金斯大学的传染病研究员（2000-01）。过去两年，她一直对艾滋病毒感染者进行流行病学和卫生服务结果研究，其中许多人是吸毒者。通过该奖项，Gebo 博士希望作为约翰·霍普金斯大学传染病系的教员，开展有关药物滥用和艾滋病毒感染之间相互作用的卫生服务研究。她将得到博士的指导。理查德·摩尔 (Richard Moore) 和尼尔·鲍威 (Neil Powe) 是艾滋病毒流行病学和卫生服务研究方面的专家，以及 Drs. 的合作。玛丽·麦考尔（Mary McCaul）和芭芭拉·特纳（Barbara Turner）建立了药物滥用和吸毒者艾滋病毒卫生服务利用方面的研究人员。为了补充她的研究，Gebo 博士将在公共卫生学院完成药物滥用、伦理以及先进生物统计学和卫生服务研究方法方面的课程。蛋白酶抑制剂被证明可以降低 HIV+ 患者的发病率和死亡率。在试点数据中，Gebo 博士发现 1995 年至 1997 年间，我们的 HIV+ 患者的住院率显着下降；然而，这种趋势在有非法药物使用史的患者中明显减弱。即使在抗逆转录病毒药物使用调整后，非法药物的使用与 HIV+ 患者的住院密切相关。为了探索这一点，Gebo 博士将对约翰·霍普金斯大学 HIV 诊所跟踪的患者进行一项队列研究，通过时间序列分析检查 1998 年至 2001 年间的住院和门诊护理利用率。她还将进行交叉研究对 2001 年在约翰霍普金斯大学 HIV 诊所登记的患者进行的截面研究，以检查预防性护理利用的充分性。在评估使用模式后，她将对药物滥用患者进行强化病例管理干预，以增加药物滥用治疗并减少药物使用。最后，她将对干预措施进行成本效益分析。该奖项的目标是确定艾滋病毒+患者过度和利用医疗保健不足的领域，并提高药物滥用治疗转诊的完成率并减少艾滋病毒+吸毒者的总体药物使用。利用现有数据源的研究、干预计划和主要数据收集、资深科学家的出色指导、可用的课程以及约翰·霍普金斯大学的支持环境相结合，将为 Gebo 博士提供她发展所需的技能成为艾滋病毒流行病学和卫生服务研究的独立临床研究员。