Abstract
Background: Japan has 381 designated AIDS core hospitals for the care of patients with HIV/AIDS. However, actual care they provide and their effectiveness has not been fully evaluated. Methods & Materials: Cross sectional study was conducted by sending letters to all 381 AIDS core hospitals. They were given access to web based questionnaire using SurveyMonkey and were asked several questions regarding the current situation about HIV/AIDS care. Results: Among 267 core hospitals among 381 (70.1%), which responded to our survey, 17 or 6.4% of the hospitals had never experienced HIV/AIDS care. While 27.6% of the hospitals stated that they take care of more than 50 patients as of the survey, 17.6% had only 1-4 patients to follow, and 14.8% had no patient to care. For the possibility of referral, 74.2% answered that they are able to accept new patients, 17.1% answered that they were not able to accept any new patients, and 13.1% answered that they were able to but not willing to accept new HIV/AIDS patients. The most common reasons for not being able to see HIV/AIDS patients was the absence of physicians who are able to take care of HIV/AIDS patients (50.9%), followed by lack of health care personnels such as social workers or counsellors (30.5%), and no aid from other subspecialties (20.3%). Conclusion: While majority of AIDS core hospitals in Japan are actively engaged in and are committed to HIV/AIDS care, some lacked experience and expertise in this field, and some even expressed unwillingness to see the patients. There might need a reform of the system to harmonize expertise and willingness of those core hospitals and needs of the community and patients. Restructuring or even abandonment of core hospital system needs to be considered since there needs more cooperation from other specialties (physicians and non-physicians) in care of AIDS/HIV patients in an era when the patients live longer and the needs for non-HIV issues such as primary care and cancer prevention/management are to be increased further.
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