Impact of Multidisciplinary Care Coordination on Health Care Utilization Among Patients Coinfected With Human Immunodeficiency Virus and Hepatitis C

多学科护理协调对同时感染人类免疫缺陷病毒和丙型肝炎病毒患者医疗资源利用的影响

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Abstract

BACKGROUND: People coinfected with HIV and hepatitis C (HCV) have complex needs that include pharmaceutical therapy, psychiatric care, and social work. Multidisciplinary care coordination (MCC) is the concerted effort to address health using a diverse team of primary care physicians, mental health specialists, and social workers. METHODS: To determine the effect of MCC in reducing avoidable hospital use, we examined longitudinal data from an academic equity-focused program in Upper Manhattan (CHP). In 2015, CHP implemented MCC, which integrated team members, panel management, and open access (walk-in) activities to better link, engage, and treat those who are coinfected. We compared health care utilization trends before 2015 ("preintervention") to after 2015 ("postintervention"). RESULTS: We found that the implementation of MCC was associated with a decrease in per-year hospital visits among those coinfected. CONCLUSION: To assist in future upscaling, we hope to identify strategies that facilitated the implementation of MCC in a setting like CHP.

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