Brief Report: Physician Reimbursement and Retention in HIV Care: Racial Disparities in the US South

Pan, Zhongzhe; Dahman, Bassam; Bono, Rose S; Sabik, Lindsay M.; Belgrave, Faye Z.; Yerkes, Lauren; Nixon, Daniel E.; Kimmel, April D.

doi:10.1097/qai.0000000000003105

JAIDS Journal of Acquired Immune Deficiency Syndromes

2023

DOI: 10.1097/qai.0000000000003105

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Brief Report: Physician Reimbursement and Retention in HIV Care: Racial Disparities in the US South

Zhongzhe Pan

Bassam Dahman

Rose S Bono

et al.

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2024

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Drive time to care and retention in HIV care: Rural–urban differences among Medicaid enrollees in the United States South

Kimmel,

Bono,

Pan

et al. 2024

The Journal of Rural Health

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PurposeLess than 50% of people with HIV (PWH) in the United States are retained in care, a key step along the HIV care continuum. We examined the impact of geographic access to care on retention in care for urban and rural PWH.MethodsWe used Medicaid claims and clinician data (Medicaid Analytic eXtract and MAX Provider Characteristics, 2009–2012) for 13 Southern states plus the District of Columbia. We calculated drive time from the enrollees’ ZIP Code Tabulation Area to their usual source of care. We used generalized estimating equations to examine the association between drive time to care >30 min (versus ≤30 min) and retention in care, overall and stratified by rurality. In sensitivity analysis, we examined the definition of retention in care, states included in the analysis, and enrollee‐ and care‐related characteristics.FindingsThe sample included 49,596 PWH. Overall, the association between drive time >30 min and retention was significant, but small (adjusted odds ratio [aOR] 1.01, 95% confidence interval [CI] 1.00, 1.01) and was not significant in urban areas; however, the significance and direction of the association differed in sensitivity analysis. In rural areas, driving >30 min to care was associated with 7% higher odds of retention in care (aOR 1.07, 95% CI 1.05, 1.08) and this association remained significant and positive in nearly all sensitivity analyses.ConclusionsFor PWH in rural areas, greater drive time is consistently associated with greater retention in care. Disentangling the mechanisms of this relationship is a future research priority.

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Drive time to care and retention in HIV care: Rural–urban differences among Medicaid enrollees in the United States South

Kimmel,

Bono,

Pan

et al. 2024

The Journal of Rural Health

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Brief Report: Physician Reimbursement and Retention in HIV Care: Racial Disparities in the US South

Cited by 1 publication

References 23 publications

Drive time to care and retention in HIV care: Rural–urban differences among Medicaid enrollees in the United States South

Drive time to care and retention in HIV care: Rural–urban differences among Medicaid enrollees in the United States South

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