Poor Schedule Management Leads to Discontinuity of Medical Attendance among Patients Infected with HIV

Fumiko Kagiura,Megumi Shimada,Masayuki Kakehashi

doi:10.4236/health.2019.113024

Abstract

Dropout from medical attendance is a well-recognized issue among patients with human immunodeficiency virus (HIV) infection. We interviewed 23 HIV-positive patients and used text mining methods to analyse the risk factors for dropout. Fifteen patients continued medical attendance and eight patients dropped out of medical attendance. Categories were extracted from the interview data of the patients who continued medical attendance (i.e., the continuity group) and the patients who dropped out of medical care (i.e., the discontinuity group). Categories of the continuity group included needing to take a day off for medical attendance, scheduling each appointment, writing down medical appointments, being grateful for the medical care, and 12 additional categories. Categories of discontinuity group included forgetting the dates of medical appointments, not needing to get a day off for medical attendance, allowing aid for medical care to expire, and 10 additional categories. The discontinuity group had poorer schedule management than the continuity group, which caused them to forget their next medical appointments and delay the renewal of aid for medical care. Thus, medical staff may be able to prevent dropouts by ensuring that patients record the dates of their medical appointments.

Highlights

We interviewed 23 human immunodeficiency virus (HIV)-positive patients and used text mining methods to analyse the risk factors for dropout
Many studies have tried to clarify factors that are associated with the discontinuation of medical care among patients infected with HIV, and most have been reported in the US or in African regions where medical insurance systems are insufficient
Participants of the continuity group expressed gratitude for medical financial aid; in contrast, participants in the discontinuity group were not able to meet the deadline for the financial aid renewal procedures that led to the loss of their designated status and caused them to discontinue medical care

Summary

Introduction

Based on demographic and clinical data, factors that were shown to be associated with discontinuation of medical care were young patients [4] [5] [6], not having started antiretroviral therapy [5] [7] [8], and not having or using health insurance, Medicare, or Medicaid (in which the latter two were specific to US citizens) [9] [10]. Some difficulties in continuing medical care brought up by patients include issues with their relationship with the medical staff, issues in the care system, lack of support from their family, inconvenient transport to the hospital, and temporal and economic restrictions. Interventions, such as improvement in the attitude of the medical staff towards the patients [12] and improvement in medical services [13], were reported to be effective for continuing medical care

Methods

Results

Discussion

Conclusion