HIGHLIGHTS
- Which Ryan White HIV/AIDS Program healthcare delivery models are effective?
- Abt analyzed three models of care Ryan White grantees use.
- The investigation found significant associations related to models of care.
The Challenge
The Ryan White HIV/AIDS Program (RWHAP), administered by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services, provides a comprehensive system of care for people living with HIV and AIDS. Although RWHAP clients have better clinical outcomes than those outside the program, little is known about how the model of care contributes to these outcomes. RWHAP providers generally follow three models of care: primary model of care, specialist model of care and integrated model of care.
The Approach
Abt Global is helping HRSA determine which program models lead to better outcomes and why. The study team is conducting a focused literature review to determine lessons learned from the three models’ application to other chronic diseases. The team is using a retrospective case-control study comparing HIV and primary health care outcomes across each of the three models. The team also will analyze the perceptions of providers and clients regarding the relative strengths and challenges offered by each model.
The Results
Quantitative analyses included provider survey respondents beyond those sampled to participate in site visits. The final analysis included more than 1,000 client observations from 70 sites where we identified the model of care. Key findings indicated that:
- RWHAP support service use was the lowest in exclusively specialty care settings (94%) compared with integrated, co-managed care and exclusively primary care settings (both at 99%)
- Viral suppression rates were higher in integrated, co-managed care settings (89%) compared with exclusively primary care models (81%) or specialty (75%) settings
- Clients at exclusively primary care settings had the highest average of outpatient ambulatory care visits