Document 0706
 DOCN  M95A0706
 TI    A model clinic for the initial evaluation and establishment of primary
       care for persons infected with human immunodeficiency virus.
 DT    9510
 AU    Samet JH; Libman H; LaBelle C; Steger K; Lewis R; Craven DE; Freedberg
       KA; Section of General Internal Medicine, Boston City Hospital,; Boston
       University School of Medicine, MA, USA.
 SO    Arch Intern Med. 1995 Aug 7-21;155(15):1629-33. Unique Identifier :
       AIDSLINE MED/95344295
 AB    BACKGROUND: The human immunodeficiency virus (HIV)-infected patients on
       initial presentation to primary medical care may have extensive problems
       relating to medical, substance abuse, psychiatric, and social issues. We
       examined a model for the initiation of primary medical care for patients
       infected with HIV at a public hospital and presented the clinical,
       educational, and research benefits associated with such a clinic.
       METHODS: Eight hundred forty-five consecutive HIV-infected outpatients
       without primary care, who presented to a municipal hospital HIV intake
       clinic, the Diagnostic Evaluation Unit, between February 1, 1990 and
       August 31, 1993, received a multidisciplinary assessment and a
       facilitated access to medical services. The performance of standardized
       initial clinical evaluation and adherence to primary care referral were
       examined. RESULTS: During the most recent study year, more than 90% of
       patients presenting to the clinic completed the intake process and 95%
       were seen at the site to which they were referred for primary medical
       care. Tests for CD4 lymphocytes, syphilis, hepatitis B, and tuberculosis
       were obtained, pneumococcal vaccinations were administered, and social
       service assessments were performed in 92% to 98% of patients completing
       the intake. The clinical setting was a site for involvement in research
       protocols and provided a focused educational experience concerning
       outpatient HIV management for medical students and residents.
       CONCLUSIONS: Establishment of a clinic dedicated to the initial
       evaluation of HIV-infected persons in a municipal hospital successfully
       evaluated and linked patients to primary care providers. The clinic
       structure enabled the standardized performance of appropriate laboratory
       tests and vaccinations and provided unique educational and research
       opportunities. We encourage other health care settings to consider the
       development of similar models for the initiation of medical care for
       persons infected with HIV.
 DE    Boston  Community Health Centers  Hospitals, Municipal  Human  HIV
       Infections/*THERAPY  Models, Organizational  Outcome Assessment (Health
       Care)  Outpatient Clinics, Hospital/*ORGANIZATION & ADMIN/UTILIZATION
       Primary Health Care/*ORGANIZATION & ADMIN  JOURNAL ARTICLE

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