Document 0980
 DOCN  M94A0980
 TI    Tailoring HIV care to community needs: the Harlem Hospital experience.
 DT    9412
 AU    Pamphile R; Flam R; el-Sadr W; Harlem Hospital Center, New York, N.Y.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):236 (abstract no. PB0956). Unique
       Identifier : AIDSLINE ICA10/94371595
 AB    OBJECTIVES: 1. To describe a unique infectious disease program based on
       community and patient needs; 2. To propose this program as a model for
       HIV care in underserved communities. BACKGROUND: In Harlem New York,
       providing HIV care presents severe challenges. Yet national program
       statistics show that Harlem Hospital Infectious Disease programs are
       very successful in attracting and retaining patients. We aimed to
       identify specific aspects of this phenomenon. METHODS: Administrators
       and care providers from each program (ID, women's and dermatology
       clinic, primary care at methdone treatment centers, CPGRA, ACTG, DOT,
       women's outreach, residency training program, AIDS education, testing,
       and case management) were interviewed with a standard questionnaire.
       Interviews included items on program objectives and underlying
       philosophy and sense of integration with other programs in the unit. The
       Chief of ID was also interviewed regarding goals and challenges in
       creating a comprehensive and cohesive unit. RESULTS: Each interviewee
       stated her/his program objectives. There was little overlap in specific
       services. However, interviewees uniformly stated quality of care as a
       key objective, with emphasis on the need to provide health care in the
       context of social and other immediate concerns. Initially, needs were
       identified during the course of clinical care; now this has expanded
       into outreach, education, and advisory comittee efforts. Inter-program
       communication and a central coordinating body appears to be crucial to
       cohesive functioning. Main constraints to the growth of the unit are
       restrictiveness of funding and lack of community resources.
       DISCUSSION/CONCLUSION: This model can be used in other settings with the
       prerequisites of enthusiasm, creativity, and a small committed start-up
       team. The importance of community linkages cannot be overemphasized.
 DE    *Community Health Services  Human  HIV Infections/*THERAPY  Interviews
       Medically Underserved Area  New York City  Quality of Health Care
       MEETING ABSTRACT

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