Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services.
Publication/Presentation Date
1-1-2014
Abstract
OBJECTIVE: We sought to quantify agreement between Institute of Medicine (IOM) and Department of Health and Human Services (DHHS) retention indicators, which have not been compared in the same population, and assess clinical retention within the largest HIV cohort collaboration in the U.S.
DESIGN: Observational study from 2008-2010, using clinical cohort data in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).
METHODS: Retention definitions used HIV primary care visits. The IOM retention indicator was: ≥2 visits, ≥90 days apart, each calendar year. This was extended to a 2-year period; retention required meeting the definition in both years. The DHHS retention indicator was: ≥1 visit each semester over 2 years, each ≥60 days apart. Kappa statistics detected agreement between indicators and C statistics (areas under Receiver-Operating Characteristic curves) from logistic regression analyses summarized discrimination of the IOM indicator by the DHHS indicator.
RESULTS: Among 36,769 patients in 2008-2009 and 34,017 in 2009-2010, there were higher percentages of participants retained in care under the IOM indicator than the DHHS indicator (80% vs. 75% in 2008-2009; 78% vs. 72% in 2009-2010, respectively) (p
CONCLUSIONS: Although the IOM indicator consistently reported higher retention in care compared with the DHHS indicator, there was strong agreement between IOM and DHHS retention indicators in a cohort demographically similar to persons living with HIV/AIDS in the U.S. Persons with poorer retention represent subgroups of interest for retention improvement programs nationally, particularly in light of the White House Executive Order on the HIV Care Continuum.
Volume
9
Issue
11
First Page
111772
Last Page
111772
ISSN
1932-6203
Published In/Presented At
Rebeiro, P. F., Horberg, M. A., Gange, S. J., Gebo, K. A., Yehia, B. R., Brooks, J. T., Buchacz, K., Silverberg, M. J., Gill, J., Moore, R. D., Althoff, K. N., & North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) (2014). Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services. PloS one, 9(11), e111772. https://doi.org/10.1371/journal.pone.0111772
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
25375099
Department(s)
Administration and Leadership
Document Type
Article