EXAMINING THE IMPACT OF CASE MANAGEMENT ON HEALTH OUTCOMES AMONG PEOPLE LIVING WITH HIV
Open Access
- Author:
- Chiu, Yung-Chen
- Graduate Program:
- Counselor Education
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- May 23, 2016
- Committee Members:
- Liza M. Conyers, Dissertation Advisor/Co-Advisor
Liza M. Conyers, Committee Chair/Co-Chair
James T. Herbert, Committee Member
Wendy A. Coduti, Committee Member
Priya Sharma, Outside Member
KB Boomer, Special Member - Keywords:
- HIV/AIDS
Case Management
Rehabilitation Counseling - Abstract:
- Case management can play an important role in facilitating linkage to and retention in care for people living with HIV (PLWH), yet many PLWH do not receive these services and the national data shows that only about 30% of PLWH are able to successfully link to medical treatment to achieve viral suppression, the gold standard of HIV care (CDC, 2011). To gain a better understanding of the use of case management services within a suburban and rural population, this study applied the Andersen Behavioral Model for Health Service Use as a framework to identify factors associated within case management practice among a sample of 704 patients who received HIV medical services from a HIV clinic in south central Pennsylvania. The study also incorporated the International Classification of Function, Disability, and Health (ICF) framework to examine the association between use of case management and PLWH’s five-year longitudinal health outcomes (CD4 percentages and retention in care). The results of the retrospective longitudinal analyses indicate racial/ethnic minority status and lack of retention in HIV medical care were associated with case management use and that case management services was positively associated with significant gains in CD4 percentage over time. Additionally, racial/ethnic minority patients and those who are younger were less likely to be remained in care, despite receipt of case management services. Due to the rural nature of the sample, African American and Hispanic populations living with HIV are underrepresented compared to the overall demographics of PLWH in the United States. Despite the benefits of case management, only small proportion of the sample used case management services. Implications for case managers and rehabilitation counseling professionals and recommendations for future research are provided.