HIV/AIDS Patient Satisfaction With Hospitalization in the Era of Highly Active Antiretroviral Therapy

Providers' HIV-related avoidance attitude and patient satisfaction

OBJECTIVES

This article explores the associations between medical care providers' attitudes towards patients living with HIV (PLH) and the service satisfaction reported from general patients.

METHODS

Data were collected from 40 county-level hospitals in China, including 1760 service providers and 1000 patients receiving medical services from the hospitals. Provider and patient assessments were conducted by self-administered questionnaires and face-to-face interviews, respectively. Random-effect regression models were used to examine relationships between the providers' avoidance attitudes and patient satisfaction at the hospital level while taking into account variations in demographics and professional experience within each hospital.

RESULTS AND CONCLUSIONS

Service providers' avoidance attitudes towards PLH were negatively associated with general patients' satisfaction with service providers at the hospital level. The relationship was strong and significant whether or not adjustments were made for background characteristics. Medical care providers' stigmatizing attitudes towards PLH could be a reflection of the providers' general outlook with all patients. This study underscores a broader focus for HIV-related stigma reduction interventions in medical settings at both individual and institutional levels, targeting attitudes towards both patients with HIV/AIDS and the general patient population.

Patient-derived outcome measures for HIV services in the developed world: a systematic review

This review sought to establish the themes and approaches used in the measurement of patient satisfaction regarded by HIV service users as crucial to improving service quality. It also investigated how feedback has been measured previously and whether a gold standard instrument exists that is generalizable across HIV inpatient and clinic settings. Twelve databases and other sources yielded 1474 titles. Using a clinically-focused question and pre-defined inclusion and exclusion criteria, 32 articles were retrieved and reviewed for quality using a quality appraisal checklist. Two reviewers used a data extraction form to identify and verify key patient experiences. Thematic analysis revealed that clinic staffs' current knowledge of HIV was an essential factor in positive feedback. Treating patients with dignity and respecting their autonomy and confidentiality were also important. Developments in treatment, extended life expectancy and quality of life have altered patients' experience and level of satisfaction. Three instruments developed to assess patient satisfaction with HIV care were identified but there was no gold standard method of measuring it. There is a need to develop a specific, valid instrument that is easy to complete and analyse, and the data should be used to inform the redesign of services to promote a dynamic model of care.

Using patient experience to measure the quality of HIV care

Measurement of health-care quality in the UK is no longer restricted to evaluating the effectiveness of treatments or the cost efficiency of services. There is a drive towards a patient-based agenda which enables them to make a clear contribution to the way services are shaped by expressing their values and sharing experiences. Positive engagement with HIV care has proven benefits to patients and the mandatory use of standardized reported outcome measures provides an opportunity to include HIV patients in the process of creating and refining an evaluation tool which places emphasis on aspects of care that are significant to them. Ultimately, this will provide services users with a stronger voice to guide appropriate service change and support the continuing improvement of HIV care.