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El. knyga: Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act

  • Formatas: 318 pages
  • Išleidimo metai: 09-Jun-2004
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309166768
Kitos knygos pagal šią temą:
  • Formatas: 318 pages
  • Išleidimo metai: 09-Jun-2004
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309166768
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The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV.

In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.



Table of Contents



Front Matter Executive Summary 1 Introduction 2 Overview of the HIV/AIDS Epidemic and the Ryan White CARE Act 3 Public Health and HIV/AIDS Surveillance 4 HIV Reporting Data and Title I and II Formulas 5 Estimating Resource Needs 6 Measuring Quality of Care 7 Findings and Recommendations Appendix A: Acronyms Appendix B: Financial Resources of States for HIV/AIDS Reporting Appendix C: Analyses of the Sensitivity of the Formula Allocations to Underlying Changes in Input Data Appendix D: Methodological Details of HCSUS Analyses Appendix E: Tables of HIV/AIDS Quality Measures from Selected Sources Appendix F: Biographies
EXECUTIVE SUMMARY 1(26)
Charge to the Committee,
3(1)
Use of HIV Data in the Title I and II Allocation Formulas,
3(11)
Estimating Resource Needs,
14(3)
Measuring Quality of Care,
17(5)
Summary,
22(1)
References,
23(4)
1 INTRODUCTION 27(14)
Impetus for this Study,
28(2)
Study Charge,
30(4)
Study Methods,
34(1)
Guiding Principles,
34(4)
Organization of the Report,
38(1)
References,
38(3)
2 OVERVIEW OF THE HIV/AIDS EPIDEMIC AND THE RYAN WHITE CARE ACT 41(32)
Overview of the HIV/AIDS Epidemic,
41(3)
Paying for HIV/AIDS Care,
44(1)
History of the CARE Act,
45(7)
Current Structure of the Act,
52(9)
Overview of CARE Act Allocation Formulas,
61(8)
References,
69(4)
3 PUBLIC HEALTH AND HIV/AIDS SURVEILLANCE 73(14)
Public Health Surveillance,
73(3)
AIDS and HIV Case Reporting,
76(4)
Other Methods for Estimating HIV Prevalence,
80(4)
References,
84(3)
4 HIV REPORTING DATA AND TITLE I AND II FORMULAS 87(48)
Capability of State HIV Reporting Systems to Provide Data for the Formulas,
90(4)
Comparability of Data Quality Across Jurisdictions,
94(24)
Relative Disease Burden and Ranking of Need Across Jurisdictions,
118(3)
Sensitivity of the Formula Allocations to Changes in the Underlying Input Data,
121(4)
Methods for Improving Data for the Formulas,
125(3)
Recommendations,
128(2)
References,
130(5)
5 ESTIMATING RESOURCE NEEDS 135(53)
Factors Affecting Resource Needs,
137(3)
Title I Supplemental Award Process,
140(4)
Criteria for Assessing Measures of Resource Needs,
144(2)
Analysis of Title I Supplemental Applications,
146(22)
Findings,
168(3)
Available Data Sources,
171(1)
Proposed Approach,
172(12)
Recommendations,
184(2)
References,
186(2)
6 MEASURING QUALITY OF CARE 188(33)
Current HRSA/HAB Quality of Care Activities,
190(4)
Four-Dimensional Conceptual Framework for HIV Quality Assessment,
194(6)
Principles for Selecting Quality-of-Care Measures,
200(2)
Existing Quality-of-Care Measures for HIV/AIDS,
202(11)
Findings,
213(2)
Recommendations,
215(2)
References,
217(4)
7 FINDINGS AND RECOMMENDATIONS 221(16)
References,
233(4)
APPENDIXES
A Acronyms
237(2)
B Financial Resources of States for HIV/AIDS Reporting
239(8)
C Analyses of the Sensitivity of the Formula Allocations to Underlying Changes in Input Data
247(14)
D Methodological Details of HCSUS Analyses
261(6)
E Tables of HIV/AIDS Quality Measures from Selected Sources
267(28)
F Biographies
295
Committee on the Ryan White CARE Act: Data for Resource Allocation, Planning and Evaluation