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Optimizing Interventions Across the HIV Care Continuum: A Case Study Using Process Improvement Analysis.

Geoffrey J Barrow1, Michael Fairley2, Margaret L Brandeau2

  • 1Faculty of Medical Sciences, University of the West Indies, Mona, Jamaica.

Operations Research for Health Care
|October 5, 2020
PubMed
Summary
This summary is machine-generated.

Applying production process analysis to HIV care delivery improves patient outcomes. This case study in Jamaica shows how process improvements and strategic investments maximize antiretroviral therapy (ART) and viral suppression rates.

Keywords:
HIVHIV care cascadeMarkov modeloptimizationprocess improvementqualitative analysis

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Area of Science:

  • Public Health
  • Health Services Research
  • Operations Research

Background:

  • The UNAIDS 90-90-90 targets aim to increase HIV diagnosis, treatment, and viral suppression.
  • Effective HIV care delivery programs are crucial for achieving these ambitious global health goals.

Purpose of the Study:

  • To demonstrate how process improvement analysis, viewing patient care as a production process, can enhance HIV care.
  • To evaluate the impact of potential improvements on antiretroviral therapy (ART) uptake and viral suppression.
  • To model optimal budget allocation for interventions in the HIV care cascade.

Main Methods:

  • Qualitative analysis to identify areas for improvement in HIV care delivery.
  • Quantitative analysis using a stochastic model to simulate the impact of process changes.
  • Development of an optimization model for resource allocation among care interventions.

Main Results:

  • Process improvement analysis identified key areas for enhancing HIV care delivery.
  • The stochastic model evaluated the effects of interventions on ART and viral suppression.
  • An investment model determined optimal allocation of a fixed budget for maximum clinical impact.

Conclusions:

  • Viewing HIV patient care as a production process enables identification of effective improvement strategies.
  • Methods are generalizable to other HIV clinics and chronic disease management programs (e.g., diabetes, hepatitis B, opioid use disorder).