News From The Annals Of Internal Medicine June 17, 2008

Main Category: HIV / AIDS
Also Included In: Seniors / Aging;  Primary Care / General Practice
Article Date: 17 Jun 2008 - 5:00 PDT

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Screening HIV in Patients Older Than 55 Years of Age is Cost-Effective

A new study examined the cost-effectiveness of HIV screening in patients from age 55 to 75. Recently revised screening guidelines issued by the CDC recommend that all patients aged 13 to 64 be tested. The study looked at economic effects of voluntary HIV screening in patients aged 55 to 75: 8,672 inpatients and outpatients at six Department of Veterans Affairs Health Care Systems, whose HIV status was unknown, were included. The authors concluded that if the tested population has an HIV prevalence of 0.1 percent or greater, HIV screening in persons from age 55 to 75 is cost-effective according to conventional definitions of cost-effectiveness. The authors also suggest that to be cost-effective, screening decisions in patients older than 64 should consider whether the patient is at increased risk, has a partner at risk for contracting HIV, or has other life-threatening conditions. Advanced age alone should not preclude screening for HIV.

Open-access Scheduling has Mixed Results

The goal of open-access scheduling of office appointments is to guarantee patients that they can see a physician on the same day that they seek an appointment. The authors assessed the impact of open-access scheduling on patient appointment availability, no-show rates, and patient and staff satisfaction in six primary care practices from 2003 to 2006. The authors found that within four months of implementation, practices were able to significantly reduce their mean wait for appointment availability. However, none of the practices attained the goal of same-day access, although most practices felt their efforts were beneficial, since implementing open-access scheduling forced a re-evaluation of office systems and staffing. The findings contrast with the more optimistic results of several previous studies, which suggests the need for large-scale research of the effects of open-access scheduling.

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Annals of Internal Medicine is published by the American College of Physicians.

Source: Steve Majewski
American College of Physicians

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