The Use of Assessment of Chronic Illness Care Technology to Evaluate the Institutional Capacity for HIV/AIDS Management

Abstract

The effectiveness of antiretroviral therapy has rendered HIV infection a manageable chronic condition. Currently, the health systems face the challenge of adopting organizational healthcare models capable of ensuring the delivery of comprehensive care. The Chronic Care Model has been reported for its effectiveness, particularly in terms of delivery system design. In this study, the Assessment of Chronic Illness Care (ACIC) questionnaire, a soft technology widely used for other chronic conditions, was employed on a teaching hospital to evaluate healthcare provided to people living with HIV/AIDS. The ACIC technology is a self-explanatory instrument which diagnoses, among the six components of the Chronic Care Model Framework, areas for quality improvements, indicating at the same time, intervention strategies and achievements. These components are healthcare network organization, delivery system design, self-management support, decision support, clinical information systems , and community. From May to October 2014, the tool was applied to the multidisciplinary teamwork at the points of care identified, as well as to the hospital management board. Respondents broadly rated care as basic. A pronounced contrast was observed from evaluation by management board and health professional staff in some components like organization of healthcare and clinical information system. The self-management support and delivery system design were the components best evaluated by the multidisciplinary team. Combined with the array of services offered, the entry points available at the hospital can ensure healthcare comprehensiveness. However, some gaps were detected, precluding the delivery of an effective care. The ACIC was considered an adequate technology to provide knowledge of the gaps, to promote productive discussions and reflections within teams and to indicate actions to achieve improvements on healthcare for people living with HIV/AIDS.

Assessment of the Perception of People Living With HIV Regarding the Quality of Outpatient Care at a Reference Facility in the Federal District, Brazil

“…In addition, patients do not feel encouraged to seek the resources available in the community. In a study conducted in 2014 at the same hospital, the institution had limited capacity to forge partnerships with community resources to care for PLHIV ( Silva et al, 2019 ). Similar results were found for other chronic conditions ( Moysés et al, 2012 ; Castro et al, 2018 ; Silva et al, 2018 ).…”

Intervención dirigida al equipo de salud para fortalecer la implementación del Modelo de Cuidados Crónicos

“…En este sentido, y en el marco del Modelo de Atención Integral de Salud Familiar y Comunitario, el MCC fue incorporado para apoyar la práctica de los profesionales que proporcionan atención a personas con EC, convirtiéndose en una oportunidad para los equipos de salud si lo manejan como una pauta que les permita orientar la forma de organizar la atención otorgada, introducir cambios, así como también monitorear la evolución de los mismos, de tal forma que los resultados esperados puedan medirse continuamente [12][13][14] . La revisión de la literatura informa resultados de intervenciones que han permitido la incorporación del MCC [15][16][17][18] , así como también evaluar los cambios de los cuidados proporcionados a los usuarios con EC, utilizando como herramienta el instrumento Assessment of Chronic Illness Care [19][20][21][22][23][24][25][26][27][28][29][30] .…”