Abstract
In this issue, Markson et al. describe the characteristics of New York state clinics caring for Medicaid- enrolled outpatients with a new AIDS diagnosis between 1987–92.1 Their work is interesting because these descriptions can be used to measure the process of care provided by various types of clinics. Results suggest that HIV/AIDS-dedicated and infectious disease clinics provide better care than community-based primary care clinics, which in turn provide better care than hospital-based general medicine clinics. While they did not measure clinical outcomes or the costs of care, Markson and colleagues do reference a literature that supports the connection between improved outcomes and the process of care, including for example, access to care and the availability of comprehensive services. Given these results, one might reasonably reconsider the proposition that HIV/AIDS care is best provided by generalists.2
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