Document 0182
 DOCN  M95A0182
 TI    Strategies for dealing with problems associated with use of services for
       HIV infection and AIDS out of region: views of providers and users.
 DT    9510
 AU    Coyle A; McGrellis S; Department of Nursing and Midwifery, University of
       Surrey,; Guildford.
 SO    BMJ. 1995 Jun 24;310(6995):1636-8. Unique Identifier : AIDSLINE
       MED/95315785
 AB    OBJECTIVES--To identify reasons why people with HIV infection and AIDS
       living within the former South West Thames Regional Health Authority use
       HIV and AIDS services outside the region, and to identify strategies for
       dealing with the problems associated with such use. DESIGN--Qualitative
       study consisting of interviews with individual subjects and focus
       groups. SETTING--Providers of services for patients with HIV infection
       and AIDS in South West Thames, central London, and Brighton. Users of
       such services resident in South West Thames. SUBJECTS--Thirty four South
       West Thames residents with HIV infection and AIDS who use or used
       services outside the former region; and 70 providers of services within
       and beyond South West Thames. RESULTS--Principal reasons for use of
       services out of the region were accessibility (15) and negative
       appraisals of local services (14). Three main strategies for dealing
       with the problems of such use were suggested by providers. These
       entailed introducing users of services outside the region to services in
       their locality (16); sharing the responsibility for care between
       providers in specialist centres and in the person's locality (10); and
       involving the person's general practitioner in their care (12). These
       strategies were deemed acceptable by 29, 30, and 20 service users
       respectively. CONCLUSION--The reasons underlying use of services for
       patients with HIV infection and AIDS outside the region offer
       suggestions for developing services in areas with a high incidence of
       such use. The suggestions advanced by service providers offer an
       acceptable framework for dealing with the problems.
 DE    Acquired Immunodeficiency Syndrome/*THERAPY  Adult  *Attitude to Health
       Catchment Area (Health)  Community Health
       Services/STANDARDS/*UTILIZATION  England  Female  Health Services
       Accessibility  Human  HIV Infections/*THERAPY  Male  Patient Acceptance
       of Health Care/*STATISTICS & NUMER DATA  Quality of Health Care
       Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).