Patients referred to an urban HIV clinic frequently fail to establish care: Factors predicting failure

Thomas P. Giordano, Fehmida Visnegarwala, A. Clinton White, Catherine L. Troisi, Ralph F. Frankowski, Christine M. Hartman, Richard M. Grimes

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

To measure the success with which patients newly entering outpatient care establish regular care, and assess whether race/ethnicity was a predictive factor, we conducted a medical record review of new patients seen 20 April 1998 to 31 December 1998 at The Thomas Street Clinic, a county clinic for uninsured persons. Patients were considered 'not established' if they never saw a physician in the 6 months after intake (the 'initial period'), 'poorly established' if seen but a >6-month gap in care began in the initial period, and 'established' if there were no such gaps. Of 404 patients, 11% were 'not established', 37% 'poorly established', and 53% 'established'. Injection drug use as HIV risk factor (IDU), admitted current alcohol and drug use, age <35 years, and CD4 count >/=200 cells/mm3 were most common in the 'not established' group and least common in the 'established' group. In multivariate ordinal logistic regression, difficulty establishing care was associated with IDU, admitted current alcohol use, and admitted former drug use. Age >35 years was protective. Half the indigent patients entering care in this single-site study fail to establish regular care. Substance use and younger age are predictors of failure to establish care.

Original languageEnglish (US)
Pages (from-to)773-783
Number of pages11
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume17
Issue number6
DOIs
StatePublished - Aug 2005
Externally publishedYes

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HIV
drug use
Alcohols
Pharmaceutical Preparations
alcohol
Poverty
outpatient care
Ambulatory Care
Medical Records
Patient Care
patient care
Logistic Models
Physicians
ethnicity
Group
Injections
logistics
physician
regression
human being

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)
  • Social Sciences (miscellaneous)

Cite this

Patients referred to an urban HIV clinic frequently fail to establish care : Factors predicting failure. / Giordano, Thomas P.; Visnegarwala, Fehmida; White, A. Clinton; Troisi, Catherine L.; Frankowski, Ralph F.; Hartman, Christine M.; Grimes, Richard M.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 17, No. 6, 08.2005, p. 773-783.

Research output: Contribution to journalArticle

Giordano, Thomas P. ; Visnegarwala, Fehmida ; White, A. Clinton ; Troisi, Catherine L. ; Frankowski, Ralph F. ; Hartman, Christine M. ; Grimes, Richard M. / Patients referred to an urban HIV clinic frequently fail to establish care : Factors predicting failure. In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2005 ; Vol. 17, No. 6. pp. 773-783.
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