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1994.09.30 :  RAND Study on HIV/AIDS Health Care

Contact: Public Health Service (AHCPR) - 301/594-1364 
          Bob Isquith   ext. 173
          Bob Griffin   ext. 169
          Paula Zeller  ext. 148
Friday, Sept. 30, 1994

           $15 MILLION STUDY SET TO IMPROVE HIV/AIDS CARE


     The RAND Corporation will launch the largest, most
comprehensive study ever undertaken of HIV/AIDS health care,
treatment costs, and sources of financing for patients under a $15
million, five-year cooperative agreement announced today by the
Public Health Service's Agency for Health care Policy and Research.

     Philip R. Lee, M.D., assistant secretary for health and
director of the PHS, said the HIV Cost and Services Utilization
Study "is especially designed to give us a continuing flow of
information that will help improve the care given to men, women and
children with HIV/AIDS in rural as well as urban areas."

     The first data from the study will be made available about two
years after it begins.

     Clifton R. Gaus, Sc.D., administrator of AHCPR, said the
project will provide policymakers, health care providers and
patients with more accurate, up-to-date information on costs of and
access to care.  "Information gained from the study will help
identify practice settings and other factors that are associated
with delivery of appropriate, high quality health care," he said.  
He noted that the populations requiring HIV/AIDS services are no
longer confined to large urban centers, where the disease was first
identified and gained its initial foothold.

     Martin Shapiro, M.D., professor of medicine at the UCLA School
of Medicine, is the principal investigator on the project for RAND,
which is located in Santa Monica, Calif.  Dr. Shapiro said the
project will enroll 3,700 randomly selected subjects receiving care
in 16 states.  Individuals enrolled in the study will receive health
care services from approximately 60 major health care providers and
120 smaller clinics or providers in 30 randomly selected locales
representing various practice settings.

     The study design specifically provides for inclusion of women
and children with HIV/AIDS in the survey sample.

     "Data collection will consist of a baseline interview and
follow-up interviews at six, 12 and 18 months," Dr. Shapiro said.

     Sam Bozzette, M.D., associate professor of medicine at the
University of California, San Diego and coprincipal investigator on
the project for RAND, said "Researchers also will abstract essential
data on service utilization, costs and severity of disease from
enrollees' billing records and other administrative materials
maintained by the provider."

     Dr. Bozzette emphasized that the confidentiality of information
obtained from individual patient records will be strictly
maintained.

     The project builds upon the earlier AIDS Costs and Service
Utilization Survey conducted by AHCPR, in which data were obtained
from sites at which HIV/AIDS health care services were delivered in
10 cities in 1991 and 1992.

     In contrast to these projects, most earlier studies of health
care delivery to persons with HIV infection have gathered data from
homogeneous patient groups, residing in single communities and
receiving services from a single provider.

     RAND investigators leading the project will be assisted by
researchers from the National Opinion Research Center at the
University of Chicago, the University of Miami, University of
California (Los Angeles and San Diego), Harvard, Brown and Boston
universities, and Jefferson, Mt. Sinai and Charles Drew Medical
colleges.

     Non-university-based researchers participating in the project
include representatives from Project HOPE, the San Francisco
Department of Public Health and Kaiser-Permanente of Northern
California.  Leading providers of services will help gather data and
participate in data analyses and scholarly aspects of the research
effort.
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