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Case managers help people with HIV obtain home health care, emotional counseling, and other support services

People who are infected with the human immunodeficiency virus (HIV) that causes AIDS need a number of supportive services in addition to medical care. These range from insurance benefits advocacy, housing, and home health care to emotional counseling and substance abuse treatment. These services can both prevent hospitalizations and enhance quality of life. Patients with the most intensive contact with their case managers (once or twice a month) are least apt to have unmet needs for home health care, emotional counseling, and other support services, according to a study supported by the Agency for Healthcare Research and Quality (HS08578).

The study found that of 2,832 HIV-infected adults receiving care, 67 percent needed at least one supportive service, and 27 percent had an unmet need for at least one service in the previous 6 months. Sixty percent of patients had case managers. Case managers are social workers, nurses, AIDS service organization staff members, or anyone else assigned to help patients get and coordinate care. Those who had case managers were 61 percent less apt to go without needed home care, half as likely to go without needed emotional counseling, and 30 percent less apt to have any unmet need. In fact, more frequent contact with a case manager, such as once or twice a month, in the previous 6 months was significantly associated with even fewer unmet needs for services.

These findings are based on analysis of the HIV Cost and Services Utilization Study (HCSUS), a national probability sample of HIV-infected adults drawn from U.S. medical providers randomly selected from metropolitan and rural counties. The study was conducted by co-principal investigators Martin F. Shapiro, M.D., Ph.D., of Brown University, and Samuel A. Bozzette, M.D., Ph.D., from the University of California, Los Angeles and RAND Corporation, first author Mitchell H. Katz, M.D., of the San Francisco Department of Public Health, and their colleagues.

See "Prevalence and predictors of unmet need for supportive services among HIV-infected persons: Impact of case management," by Dr. Katz, William E. Cunningham, M.D., M.P.H., Vincent Mor, Ph.D., and others, in the January 2000 Medical Care 38(1), pp. 58-69.

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