Nemes MI, Melchior R, Donini A, Basso CR, Castanheira ER, Britto e Alves MT, David JS, Braga P, Tunala LG; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. MoPeB3308.

QualiAids Group-Preventive Medicine Department- U.of Sao Paulo Medical School, Sao Paulo, Brazil

BACKGROUND: In 1999, an evaluation on HAART adherence of 8580 patients from 27 health services in Sao Paulo State, Brazil showed that the main variables explaining the non adherence are the provided health care characteristics. This result was the basis of this study now focused on quality of care. METHODS: The teams answered a structured questionnaire with 157 questions focused on service delivery, resources availability and management. The questions were based on 2 quality criteria: structure and integration of the process of care . It was established a "gold standard" based on the classification of each component of care according to indicators: appropriate structure ; prioritization of important work targets; use of different and specific technical approaches; team integration; evaluation activities, and communication between team and patients. The answers were classified in 3 scores: 0, 1, 2. The services were ranked according to the mean of scores of all variables. The gold standard mean is 1,8. RESULTS: The mean score was 1,12 (37,8 % below the gold standard) with the maximum of 1,41 and the minimum of 0,82. The highest means were obtained from the indicator use of different and specific technical approaches, and the lowest from the use of evaluation activities. The K-Means Cluster analysis distinguished 3 levels of quality. 62 questions (70,45%) showed difference between the groups. The criteria of integration showed more difference than the criteria of appropriate structure. CONCLUSIONS: There is an important variation in quality of care in these 27 services. The integration of care process is the critical attribute in the quality. These results have been used to define an instrument to evaluate quality of care in a national scale.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• Brazil
• Health Services
• Health Services Research
• Humans
• Questionnaires

Other ID:

• GWAIDS0015061

UI: 102252559

From Meeting Abstracts