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Access to and utilization of primary care services among HIV-infected women
H Palacio1, C H Shiboski, E H Yelin
1AIDS Program at San Francisco General Hospital, Department of Medicine, University of California, San Francisco, School of Medicine, USA. herminia_palacio@dph.sf.ca.us
Objectives:
To identify factors associated with the use of medical services, and to test a model of access to care, among HIV-infected women.
Methods:
A cross-sectional telephone survey was administered to 213 HIV-infected women. Outcomes were having a primary care provider, and use of primary care and emergency health services. Predictors included characteristics of the population-at-risk and of the health care system.
Results:
Ninety-three percent of respondents had a primary care provider. Linear regression found age >45 years (p = .002), perceiving greater barriers to getting to a clinic (p = .04) and greater benefits from medications (p = .03), lack of problems with appointment times (p = .02), having AIDS (p = .01), shorter appointment waiting times (p = .0003), and greater cost of travel to care (p = .001) were associated with a greater number of primary care visits. Thirty-seven percent missed at least 1 primary care appointment. In logistic regression, lack of insurance (odds ratio [OR] = 2.76), current injection drug use (OR = 2.89) and difficulty remembering appointments (OR = 2.36) were associated with having missed any appointments.
Conclusions:
Characteristics of the population-at-risk and of the health care system both make important contributions to primary care service use.