Abstract
The effectiveness of antiretroviral treatment has transformed HIV infection into a chronic transmissible condition, requiring health systems to adapt in order to care for people living with HIV. The Chronic Care Model (CCM) is the gold standard for this type of care in many countries. Among its tools, the Patient Assessment of Chronic Illness Care (PACIC) questionnaire gives the patient’s perspective of the care provided. The aim of the present study was to adapt and apply, for the first time, the questionnaire to people living with HIV to determine their perception of the quality of care provided at a reference hospital in the Federal District of Brazil. This is a case study conducted in 2019 at a teaching hospital, with a convenience sample of 30 individuals treated for at least 1 year at the facility. The median PACIC score (3.5 with a range of 1.0–5.0) seems to suggest that the users perceive the outpatient care provided by the hospital as being basic. The “delivery system design/decision support” component was deemed the best (5.0, with a range of 1.0–5.0) and “follow-up/coordination” the worst (1.0, with a range of 1.0–5.0). The results suggest the need to improve the organization of care and make adequate use of community resources, in line with the CCM. The questionnaire makes it possible to determine the strengths and weaknesses of the care provided to people living with HIV and can be used as a planning and monitoring tool to improve management of the condition, with the contribution of the patient, in particular, thereby strengthening self-care.
Highlights
Since the onset of the epidemic, HIV has caused around 32 million deaths worldwide (World Health Organization, 2019)
According to the medical charts, more than 76% exhibited undetectable viral load, even though around 35% used the preferential scheme in line with the Brazilian protocol (Brasil, 2018)
The Patient Assessment of Chronic Illness Care (PACIC) results showed that the people living with HIV treated at this reference hospital considered that the quality of the outpatient care provided was basic
Summary
Since the onset of the epidemic, HIV has caused around 32 million deaths worldwide (World Health Organization, 2019). Estimates of the prevalence of people living with HIV (PLHIV) worldwide and in Brazil were 0.49 and 0.41%, respectively at the end of 2018 (World Health Organization, 2019). Due to the effectiveness of preventive measures, diagnoses and health care in PLHIV, the condition is considered chronic, that is, involving continuous management for several years. One of the tools of the Chronic Care Model (CCM), used internationally to organize chronic care, is the Patient Assessment of Chronic Illness Care (PACIC) (Wagner, 1998; Wagner et al, 2001; Bodenheimer et al, 2002). The questionnaire evaluates the quality of care from the patient’s perspective, assessing the components of the CCM and the performance of teams in promoting self-care (Wagner et al, 2001; Glasgow et al, 2005)
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