Definition of a core set of quality indicators for the assessment of HIV/AIDS clinical care: A systematic review

BMC Health Services Research (Impact Factor: 1.71). 06/2013; 13(1):236. DOI: 10.1186/1472-6963-13-236
Source: PubMed


Several organizations and individual authors have been proposing quality indicators for the assessment of clinical care in HIV/AIDS patients. Nevertheless, the definition of a consensual core set of indicators remains controversial and its practical use is largely limited. This study aims not only to identify and characterize these indicators through a systematic literature review but also to propose a parsimonious model based on those most used.
MEDLINE, SCOPUS, Cochrane databases and ISI Web of Knowledge, as well as official websites of organizations dealing with HIV/AIDS care, were searched for articles and information proposing HIV/AIDS clinical care quality indicators. The ones that are on patient's perspective and based on services set were excluded. Data extraction, using a predefined data sheet based on Cochrane recommendations, was done by one of the authors while a second author rechecked the extracted data for any inconsistency.
A total of 360 articles were identified in our search query but only 12 of them met the inclusion criteria. We also identified one relevant site. Overall, we identified 65 quality indicators for HIV/AIDS clinical care distributed as following: outcome (n=15) and process-related (n=50) indicators; generic (n=36) and HIV/AIDS disease-specific (n=29) indicators; baseline examinations (n=19), screening (n=9), immunization (n=4), prophylaxis (n=5), HIV monitoring (n=16), and therapy (=12) indicators.
There are several studies that set up HIV clinical care indicators, with only a part of them useful to assess the HIV clinical care. More importantly, HIV/AIDS clinical care indicators need to be valid, reliable and most of all feasible.

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    • "Ahonkhai and colleagues [12] focus on the “continuum of care” for HIV/AIDS from HIV testing and diagnosis to antiretroviral therapy initiation and follow-up, in their call for improved indicators to evaluate local interventions in resource-limited settings. The systematic review of quality indicators for clinical care provision in HIV/AIDS by Catumbela et al. [13] similarly focuses on indicators for screening of opportunistic diseases and sexually transmitted infections, immunization, prophylaxis, HIV monitoring and therapy. This focus on clinical care neglects the social outcomes of care provision, including issues of inequalities in access to care for marginalized groups. "
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