Document 0791
 DOCN  M95A0791
 TI    Satisfaction with ambulatory care of persons with AIDS: predictors of
       patient ratings of quality.
 DT    9510
 AU    Stone VE; Weissman JS; Cleary PD; Department of Medicine, Boston City
       Hospital, Boston University; School of Medicine, MA 02118, USA.
 SO    J Gen Intern Med. 1995 May;10(5):239-45. Unique Identifier : AIDSLINE
       MED/95341421
 AB    OBJECTIVE: To examine the relation of patient characteristics and site
       of care to the perception of ambulatory care quality by persons with
       AIDS (PWAs). DESIGN: Patient surveys and medical record review were used
       to determine PWAs' perceptions of their ambulatory care, self-perceived
       health status, primary care relationships, sociodemographic
       characteristics, and severity of illness. SETTING: A public-hospital HIV
       clinic, an academic group practice, and a staff-model health maintenance
       organization (HMO) that together care for 20% of all Massachusetts PWAs.
       PATIENTS: All active patients as of February 12, 1990, and all new AIDS
       patients at each of the three sites during the subsequent 13 months.
       MEASUREMENTS AND MAIN RESULTS: The primary outcome measure was a
       six-item scale of patient-rated quality of care (PRQC), a newly
       developed measure that combined patients' ratings of their physician
       care, nursing care, involvement in medical decisions, and overall
       quality of care. Multiple logistic regression was carried out with low
       PRQC (lowest quartile) as the dependent variable, to identify correlates
       of patient perceptions of poor quality. Patients who had a primary nurse
       were significantly less likely to have low PRQC scores (OR = 0.50, 95%
       CI = 0.26 to 0.97). Black patients and patients who used injection drugs
       were significantly more likely to rate their care in the lowest quartile
       (OR = 2.22, 95% CI = 1.04 to 4.78; and OR = 2.43, 95% CI = 1.13 to 5.23,
       respectively), as were those who had lower self-perceived health status,
       after controlling for confounders; no association was found by site or
       severity. CONCLUSIONS: These results show that primary nursing may be an
       important determinant of how PWAs rate the quality of their ambulatory
       care. Furthermore, PWAs who are black or who are injection drug users
       are less satisfied than are others with the quality of their ambulatory
       AIDS care.
 DE    Acquired Immunodeficiency Syndrome/NURSING/*PSYCHOLOGY/THERAPY
       Ambulatory Care/STATISTICS & NUMER DATA/*STANDARDS  Female  Health
       Status  Human  Logistic Models  Male  Patient
       Satisfaction/ETHNOLOGY/*STATISTICS & NUMER DATA  Perception  Primary
       Nursing Care/STATISTICS & NUMER DATA/STANDARDS  Quality of Health
       Care/*STATISTICS & NUMER DATA  Self Concept  Substance Abuse,
       Intravenous/PSYCHOLOGY  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

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