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APHA 1996 Abstract: Developing Information Systems That Support the
Delivery of HIV Care in a Managed Care Environment
Presented at: American Public Health Association 124th Annual Meeting, November 1996
Developing Information Systems That Support the Delivery of HIV Care in
a Managed Care Environment
Richard Moore, MD. A range of data is required in order to
deliver HIV care in a managed care system. Accurate information concerning service
utilization and cost of care for persons with HIV/AIDS at different points in the course
of their illness is used to perform rate calculation and appropriate risk adjustment.
Optimally, a database provides information critical to the financial stability of the care
system, while also providing clinicians with information needed to best manage patients. A
comprehensive database with demographic, clinical, and laboratory data from both inpatient
and outpatient records funded by the Agency for Health Care Policy and Research is
available to the HIV Care Program. This database has been combined with the Maryland
Medicaid charge and payment data to permit full cost analysis. This system has the ability
to quantitate financial risk for patients in various categories such as CD4 cell count,
demographics such as injection drug use, and selected opportunistic infections, such as
CMV retinis and toxoplasmosis. JHU data reveal a strong relationship between patients with
AIDS and those who are HIV positive, and monthly payments appear to be affected by the
presence of specific opportunistic infections.
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