Not everyone diagnosed with HIV comes in for treatment after being referred to an HIV clinic, and these "no show" patients are an important reservoir of untreated people in the community. Mugavero et al identified risk factors associated with this type of behavior. The authors are from the University of Alabama at Birmingham.
In the study group 31% of patients did not show up for HIV care.
Parameters:
(1) gender
(2) race
(3) health insurance
(4) time interval required to establish a new patient visit at the clinic (waiting time)
|
Parameter |
Finding |
Points |
|
gender |
male |
0 |
|
|
female |
1 |
|
race |
White |
0 |
|
|
minority |
1 |
|
health insurance |
private health insurance |
0 |
|
|
no private health insurance |
1 |
|
time interval to first appointment |
short |
0 |
|
|
long |
1 |
where:
• Many of the no-show patients were uninsured.
total number of risk factors for being a no-show =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The more risk factors that are present, the greater the risk that a patient may not show up for therapy.
Additional factors not mentioned but which may be interesting to study:
(1) followup mechanism in case the patient does not show (most patients in the study were self-referrals)
(2) patient's feeling of well-being (may not consider therapy necessary)
(3) denial of diagnosis
(4) having children or others relying on the patient
(5) drug addiction, prostitution or other risk factors for becoming HIV positive
Purpose: To identify a patient with newly diagnosed HIV who is unlikely to show up at an HIV clinic to keep an appointment ("no show").
Specialty: Infectious Diseases, Pharmacology, clinical
Objective: compliance/adherence, quality of life, psychological response
ICD-10: B20,
