Targeting AIDS prevention and treatment toward HIV-1-infected persons: the concept of early intervention

Article Abstract:

There is currently no cure or vaccine available for patients with acquired immunodeficiency syndrome (AIDS) and the number of HIV-positive individuals is spreading rapidly. The human immunodeficiency virus (HIV) is thought to be responsible for the development of the disease and those who test positive are likely to eventually develop AIDS. Therefore, the containment of HIV needs to be a top priority if AIDS is to be controlled. The authors discuss the creation of specialized outpatient facilities equipped with state-of-the-art clinical therapies, both physical and psychological, and specifically designed for HIV-positive individuals. What they propose is a logical extension of existing risk reduction programs which involve counseling, testing, and education. By providing early intervention, it is thought that these facilities would greatly aid in reducing the number of individuals infected with the virus. Advantages include: the early treatment of effected individuals, reduction of the spread of the virus, more effective use of clinical resources, improvement of statistical data on the number of infected people, and improved quality of life for those who suffer from AIDS. The drawbacks of such programs are identified as the negative psychological impact of the individual's knowledge of his infection, negative social repercussions toward infected individuals, and the financial cost of these programs. The authors have already begun a pilot program where intervention centers have been set up and some have been in operation for over a year. Thus far, the reaction by the participants has been very positive.

Care and treatment, Prevention, HIV (Viruses), HIV, AIDS (Disease), AIDS virus carriers, HIV carriers, AIDS-related complex

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Hospitalization charges, costs, and income for firearm-related injuries at a university trauma center

Article Abstract:

Private insurance companies may be subsidizing the cost of treating firearm injuries. The 1995 actual cost of medical care for firearm injuries in the U.S. is estimated at $4 billion, projected from costs of a large California medical center. Of 11,214 trauma admissions to the University of California, Davis, Medical Center (UCDMC), 750 had injuries from firearms. About 70% did not have private insurance. The hospital received $14.7 million in reimbursement on charges of $39.2 million, but the losses were counterbalanced by cost shifting to private insurance companies and to a lesser degree, Medicare. About $2.2 million was provided by Medi-Cal or other government-sponsored programs for 495 patients, while $6.5 million was paid by private insurance for 255 patients. The rest of the patients were uninsured. A majority of patients were males between 15 and 29 years, and 33% were African Americans. Emergency surgery was performed on 48% of patients.

Economic aspects, Finance, Gunshot wounds

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Establishing Health Care Performance Standards in an Era of Consumerism

Article Abstract:

The National Quality Forum is a private, not-for-profit, public benefit corporation whose goal is to develop a national strategy for health care quality improvement. The primary tactic for meeting this goal is the measurement and public reporting of health care quality data and an emphasis on using this data to support health care purchasing decisions.

United States, Quality management, Medical care quality, Associations, Performance standards, Job performance standards

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