Philip Todd Korthuis1, Kathleen A McGinnis2, Kevin L Kraemer2, Adam J Gordon3,4, Melissa Skanderson2, Amy C Justice5,6, Stephen Crystal7, Matthew Bidwell Goetz8, Cynthia L Gibert9, David Rimland10, Lynn E Fiellin5, Julie R Gaither11, Karen Wang5, Steven M Asch12, Donald Keith McInnes13, Michael E Ohl14, Kendall Bryant15, Janet P Tate5,6, Mona Duggal16,17, David A Fiellin5. 1. Oregon Health & Science University, Portland. 2. VA Pittsburgh Healthcare System. 3. Center for Health Equity Research and Promotion. 4. Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania. 5. Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDS, Yale University School of Medicine. 6. Veterans Aging Cohort Study Coordinating Center. 7. The Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey. 8. VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA. 9. VA Medical Center and George Washington University Medical Center, Washington D.C. 10. VA Medical Center and Emory University School of Medicine, Atlanta, Georgia. 11. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven. 12. VA Greater Palo Alto Healthcare System and Stanford University, California. 13. Boston University, Massachusetts. 14. University of Iowa Carver College of Medicine, Iowa City. 15. HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland. 16. VA Connecticut Care System, West Haven, Connecticut. 17. Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
BACKGROUND: The Patient Protection and Affordable Care Act encourages healthcare systems to track quality-of-care measures; little is known about their impact on mortality rates. The objective of this study was to assess associations between HIV quality of care and mortality rates. METHODS: A longitudinal survival analysis of the Veterans Aging Cohort Study included 3038 human immunodeficiency virus (HIV)-infected patients enrolled between June 2002 and July 2008. The independent variable was receipt of ≥80% of 9 HIV quality indicators (QIs) abstracted from medical records in the 12 months after enrollment. Overall mortality rates through 2014 were assessed from the Veterans Health Administration, Medicare, and Social Security National Death Index records. We assessed associations between receiving ≥80% of HIV QIs and mortality rates using Kaplan-Meier survival analysis and adjusted Cox proportional hazards models. Results were stratified by unhealthy alcohol and illicit drug use. RESULTS: The majority of participants were male (97.5%) and black (66.8%), with a mean (standard deviation) age of 49.0 (8.8) years. Overall, 25.9% reported past-year unhealthy alcohol use and 28.4% reported past-year illicit drug use. During 24 805 person-years of follow-up (mean [standard deviation], 8.2 [3.3] years), those who received ≥80% of QIs experienced lower age-adjusted mortality rates (adjusted hazard ratio, 0.75; 95% confidence interval, .65-.86). Adjustment for disease severity attenuated the association. CONCLUSIONS: Receipt of ≥80% of select HIV QIs is associated with improved survival in a sample of predominantly male, black, HIV-infected patients but was insufficient to overcome adjustment for disease severity. Interventions to ensure high-quality care and address underlying chronic illness may improve survival in HIV-infected patients.
BACKGROUND: The Patient Protection and Affordable Care Act encourages healthcare systems to track quality-of-care measures; little is known about their impact on mortality rates. The objective of this study was to assess associations between HIV quality of care and mortality rates. METHODS: A longitudinal survival analysis of the Veterans Aging Cohort Study included 3038 human immunodeficiency virus (HIV)-infectedpatients enrolled between June 2002 and July 2008. The independent variable was receipt of ≥80% of 9 HIV quality indicators (QIs) abstracted from medical records in the 12 months after enrollment. Overall mortality rates through 2014 were assessed from the Veterans Health Administration, Medicare, and Social Security National Death Index records. We assessed associations between receiving ≥80% of HIV QIs and mortality rates using Kaplan-Meier survival analysis and adjusted Cox proportional hazards models. Results were stratified by unhealthy alcohol and illicit drug use. RESULTS: The majority of participants were male (97.5%) and black (66.8%), with a mean (standard deviation) age of 49.0 (8.8) years. Overall, 25.9% reported past-year unhealthy alcohol use and 28.4% reported past-year illicit drug use. During 24 805 person-years of follow-up (mean [standard deviation], 8.2 [3.3] years), those who received ≥80% of QIs experienced lower age-adjusted mortality rates (adjusted hazard ratio, 0.75; 95% confidence interval, .65-.86). Adjustment for disease severity attenuated the association. CONCLUSIONS: Receipt of ≥80% of select HIV QIs is associated with improved survival in a sample of predominantly male, black, HIV-infectedpatients but was insufficient to overcome adjustment for disease severity. Interventions to ensure high-quality care and address underlying chronic illness may improve survival in HIV-infectedpatients.
Authors: Amal N Trivedi; Sierra Matula; Isomi Miake-Lye; Peter A Glassman; Paul Shekelle; Steven Asch Journal: Med Care Date: 2011-01 Impact factor: 2.983
Authors: P Todd Korthuis; David A Fiellin; Rongwei Fu; Paula J Lum; Frederick L Altice; Nancy Sohler; Mary J Tozzi; Steven M Asch; Michael Botsko; Margaret Fishl; Timothy P Flanigan; Joshua Boverman; Dennis McCarty Journal: J Acquir Immune Defic Syndr Date: 2011-03-01 Impact factor: 3.731
Authors: Michael Horberg; Leo Hurley; William Towner; Rebecca Gambatese; Daniel Klein; Diana Antoniskis; Winkler Weinberg; Peter Kadlecik; Carol Remmers; Robert Dobrinich; Charles Quesenberry; Michael Silverberg; Michael Johnson Journal: AIDS Patient Care STDS Date: 2011-01 Impact factor: 5.078
Authors: Amy C Justice; Sharada P Modur; Janet P Tate; Keri N Althoff; Lisa P Jacobson; Kelly A Gebo; Mari M Kitahata; Michael A Horberg; John T Brooks; Kate Buchacz; Sean B Rourke; Anita Rachlis; Sonia Napravnik; Joseph Eron; James H Willig; Richard Moore; Gregory D Kirk; Ronald Bosch; Benigno Rodriguez; Robert S Hogg; Jennifer Thorne; James J Goedert; Marina Klein; John Gill; Steven Deeks; Timothy R Sterling; Kathryn Anastos; Stephen J Gange Journal: J Acquir Immune Defic Syndr Date: 2013-02-01 Impact factor: 3.731
Authors: Janet P Tate; Amy C Justice; Michael D Hughes; Fabrice Bonnet; Peter Reiss; Amanda Mocroft; Jacob Nattermann; Fiona C Lampe; Heiner C Bucher; Timothy R Sterling; Heidi M Crane; Mari M Kitahata; Margaret May; Jonathan A C Sterne Journal: AIDS Date: 2013-02-20 Impact factor: 4.177
Authors: Hasina Samji; Angela Cescon; Robert S Hogg; Sharada P Modur; Keri N Althoff; Kate Buchacz; Ann N Burchell; Mardge Cohen; Kelly A Gebo; M John Gill; Amy Justice; Gregory Kirk; Marina B Klein; P Todd Korthuis; Jeff Martin; Sonia Napravnik; Sean B Rourke; Timothy R Sterling; Michael J Silverberg; Stephen Deeks; Lisa P Jacobson; Ronald J Bosch; Mari M Kitahata; James J Goedert; Richard Moore; Stephen J Gange Journal: PLoS One Date: 2013-12-18 Impact factor: 3.240
Authors: Mehri S McKellar; Maragatha N Kuchibhatla; Kris Ann K Oursler; Stephen Crystal; Kathleen M Akgün; Kristina Crothers; Cynthia L Gibert; Karen Nieves-Lugo; Julie Womack; Janet P Tate; Gerda G Fillenbaum Journal: AIDS Res Hum Retroviruses Date: 2019-06-18 Impact factor: 2.205
Authors: Kevin L Kraemer; Kathleen A McGinnis; David A Fiellin; Melissa Skanderson; Adam J Gordon; Jonathan Robbins; Susan Zickmund; Kendall Bryant; P Todd Korthuis Journal: J Subst Abuse Treat Date: 2019-05-07
Authors: Philip T Korthuis; Paula J Lum; Pamela Vergara-Rodriguez; Keith Ahamad; Evan Wood; Lynn E Kunkel; Neal L Oden; Robert Lindblad; James L Sorensen; Virgilio Arenas; Doan Ha; Raul N Mandler; Dennis McCarty Journal: Addiction Date: 2017-02-08 Impact factor: 6.526
Authors: Corinne M Rhodes; Yuchiao Chang; Susan Regan; Daniel E Singer; Virginia A Triant Journal: Open Forum Infect Dis Date: 2017-01-31 Impact factor: 3.835
Authors: Joëlla W Adams; Kendall J Bryant; E Jennifer Edelman; David A Fiellin; Julie R Gaither; Adam J Gordon; Kirsha S Gordon; Kevin L Kraemer; Matthew J Mimiaga; Don Operario; Janet P Tate; Jacob J van den Berg; Amy C Justice; Brandon D L Marshall Journal: AIDS Behav Date: 2018-04
Authors: Michael A Horberg; Julia M Certa; Kevin B Rubenstein; Leo B Hurley; Derek D Satre; Peter M Kadlecik; Michael J Silverberg Journal: AIDS Patient Care STDS Date: 2020-11 Impact factor: 5.078