1. Reducing Disparities: A Virtual Quality Improvement Collaborative Resulted in Better Health Outcomes for 4 Target Populations Disproportionately Affected by HIV
- Author
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Rakkoo Chung, James M. Tesoriero, Clemens Steinbock, Shu-Yin John Leung, Jennifer E Lee, and Charles Kolesar
- Subjects
Male ,Quality management ,Adolescent ,Population ,MEDLINE ,Human immunodeficiency virus (HIV) ,HIV Infections ,Context (language use) ,medicine.disease_cause ,Men who have sex with men ,Sexual and Gender Minorities ,Acquired immunodeficiency syndrome (AIDS) ,Outcome Assessment, Health Care ,Humans ,Medicine ,Homosexuality, Male ,education ,education.field_of_study ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,medicine.disease ,Quality Improvement ,United States ,Health equity ,Female ,business ,Demography - Abstract
Context Although viral suppression rates have recently increased among people with HIV, specific populations still experience disparities in health outcomes, a priority in the national response to end the HIV epidemic. Purpose The end+disparities ECHO Collaborative, a quality improvement initiative among HIV providers in the United States from June 2018 to December 2019, created virtual communities of practice to measurably increase viral suppression rates in populations disproportionately affected by HIV: men who have sex with men of color, Black/African American and Latina women, youth aged 13 to 24 years, and transgender people. Methods Participating Ryan White HIV/AIDS Program-funded providers prioritized their improvement efforts to focus on one target population and joined virtual affinity sessions with other providers focused on that population for guidance by subject matter experts and exchanges with peer providers. During 9 submission cycles, providers reported their viral suppression data for the preceding 12 months. Main outcome measures The principal outcome measures were changes in viral suppression rates among 4 target populations and changes in viral suppression gaps compared with the rest of HIV-infected patients served by the same agency. Results A total of 90 providers were included in the data analyses with an average of 110 775 reported patients, out of which 19 442 represented the targeted populations. The average viral suppression rates for agency-selected populations increased from 79.2% to 82.3% (a 3.9% increase), while the remaining caseload increased at a lower rate from 84.9% to 86.1% (a 1.4% increase). The viral suppression gap was reduced from 5.7% to 3.8%, a 33.5% reduction. Improvements were found across all target populations. Conclusions The collaborative demonstrated improved health outcomes and reductions in HIV-related health disparities, moving toward ending the HIV epidemic. The model of utilizing low-cost videoconferencing technologies to create virtual communities of learning is well suited to mitigate other disease-related disparities, nationally and abroad.
- Published
- 2021
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