CONSISTENCY IN MAINTAINING CONTACT WITH HIV-RELATED SERVICE PROVIDERS- AN ANALYSIS OF THE AIDS COST AND SERVICES UTILIZATION STUDY (ACSUS)

Patients (n=1949) infected with HIV were recruited for the AIDS Cost & Service Utilization Survey (ACSUS) from ten U.S. cities and administe red face to face interviews at three month intervals over an 18 month period from. The interview was designed to obtain information at each wave of data collection on the use of the following services: ambulato ry care, hospitalization, emergency room use, support groups/counselin g, drug and alcohol treatment, and dental care. Patients were found to be highly consistent in their patterns of utilization across time, re gardless of the service in question. Of the patients who reported usin g an emergency room (FR) at Time 1, 52% also reported using an ER duri ng the next three months later at Time 2. Of those who reported having been hospitalized during the Time 1 reporting period, almost 58% repo rted a hospitalization again at Time 2. Next, use of a service at Time 6 (n=1404, 72.2%) was regressed onto whether the person received the service at Time 2 and the personal, financial, and medical variables. Except for dental services, utilization of a service one year in the p ast (Time 2) was the strongest predictor of Time 6 use. The findings i ndicated that the one factor consistently related to service use withi n this sample is a factor (as opposed to education, race, or even insu rance) that is amenable to intervention: previous use of that service. The individuals studied established patterns of service utilization t hat are of reasonably long duration once they began use of a service. This continuity of care becomes more critical as the initiation of tre atments begins with the diagnosis of HN rather than AIDS. Findings sug gest that HIV outreach efforts be targeted to increasing early use of medical and behavioral services in ambulatory care settings.