The Impact of Formal Social Support on Outpatient Care Among a Sample of Adults Living with HIV/AIDS in the United States

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dc.contributor.advisorBoekeloo, Ph.D., Bradley O.en_US
dc.contributor.authorMatoff-Stepp, Sabrina Aen_US
dc.contributor.departmentPublic and Community Healthen_US
dc.contributor.publisherDigital Repository at the University of Marylanden_US
dc.contributor.publisherUniversity of Maryland (College Park, Md.)en_US
dc.date.accessioned2008-04-22T16:03:50Z
dc.date.available2008-04-22T16:03:50Z
dc.date.issued2007-11-19en_US
dc.description.abstractBackground The HIV Cost and Services Utilization Study and HIV Research Network (HIVRN) clinical studies showed disparities among HIV-positive men and women in outpatient care use in the U.S. Formal social support provided by case managers may help patients access outpatient care. The primary purpose of this study was to determine if having case managers is associated with levels of outpatient care visits among 797 individuals living with HIV/AIDS, and whether this association varies by patient sex. Other aims were to determine if the number of in-person case management visits and the type of formal social support are associated with these same outcomes. Outpatient visit levels were defined as 2-5 (average) or 6+ (high). Based on Andersen's (1995) Behavioral Model of Health Services Use, a conceptual model was developed as a framework for examining the study's hypothesized relationships. Methods The HIVRN is a convenience sample of 17 U.S. clinical sites serving more than 15,000 people living with HIV/AIDS. In 2003, interviews were conducted with a stratified sample of 951 clients at 14 HIVRN sites. The current study sample consisted of 797 adult respondents (543 males and 254 females). Logistic regression was used to identify significant predictors of outpatient care visit levels. Results Patients who had one or two case managers versus no case managers were significantly more likely to have 6+ outpatient visits, while patients who were employed and had higher self-reported perceptions of their health were significantly less likely to have 6+ outpatient visits. These relationships did not vary by patient sex. Level of outpatient visits also did not vary by patient sex. No significant associations were found between the number of in-person case management visits or the type of formal social support and level of outpatient visits. In sub-analyses that separated patients with one case manager from those with two case managers, no new predictors emerged. Conclusion Case management was associated with higher levels of outpatient visits for both male and female patients in this study. This finding suggests that utilization of HIV-related outpatient care may be increased among both men and women with case management.en_US
dc.format.extent2136780 bytes
dc.format.mimetypeapplication/pdf
dc.identifier.urihttp://hdl.handle.net/1903/7661
dc.language.isoen_US
dc.subject.pqcontrolledHealth Sciences, Public Healthen_US
dc.subject.pquncontrolledHIV/AIDSen_US
dc.subject.pquncontrolledsocial supporten_US
dc.subject.pquncontrolledcase managementen_US
dc.subject.pquncontrolledhealth disparitiesen_US
dc.subject.pquncontrolledhealth policyen_US
dc.subject.pquncontrolledoutpatient careen_US
dc.titleThe Impact of Formal Social Support on Outpatient Care Among a Sample of Adults Living with HIV/AIDS in the United Statesen_US
dc.typeDissertationen_US

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