Washington state satellite HIV clinic program: a model for delivering highly effective decentralized care in under-resourced communities^*

* Data in this manuscript were presented at the ID Week 2016 Conference in New Orleans, LA, USA (Oct. 26-30, 2016). Title: “Washington State Satellite HIV Clinic Program: Delivering Highly Effective Decentralized Care for Patients in Underserved Communities.” Abstract #499.

ABSTRACT

To improve access to high-quality HIV care in underserved regions of Western Washington (WA) State, we collaborated with the WA State Department of Health (DOH) and community partners to launch four satellite HIV clinics. Here, we describe this innovative clinical care model, present an estimate of costs, and evaluate patient care outcomes, including virologic suppression rates. To accomplish this, we assessed virologic suppression rates 12 months before and 12 months after the satellite clinics opened, comparing people living with HIV (PLWH) who enrolled in the satellite clinics versus all PLWH in the same regions who did not. We also determined virologic suppression rates in 2015 comparing satellite clinic versus non-satellite clinic patients and compared care quality indicators between the satellite clinics and the parent academic clinic. Results demonstrate that the change in virologic suppression rate 12 months before to 12 months after the satellite clinics opened was higher for patients who enrolled in the satellite clinics compared to all those in the same region who did not (18% versus 6%, p < 0.001). Virologic suppression in 2015 was significantly higher for satellite clinic than non-satellite clinic patients at three of four sites. Care quality indicators were met at a high level at the satellite clinics, comparable to the parent academic clinic. Overall, through community partnerships and WA DOH support, the satellite clinic program increased access to best practice HIV care and improved virologic suppression rates in difficult-to-reach areas. This model could be expanded to other regions with inadequate access to HIV practitioners, though financial support is necessary.

KEYWORDS:

• HIV
• AIDS
• delivery of healthcare
• continuity of care
• rural

Acknowledgments

The authors would like to thank the Washington State Department of Health for ongoing support and collaboration, as well as our multiple community partners: Kitsap Public Health District, Community Health Centers of Snohomish County, SeaMar Community Health Centers, and the University of Washington Neighborhood Clinic Network. We are grateful for the outstanding nurses, case managers, and other staff at all of the sites who help make this program possible.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Brian R. Wood http://orcid.org/0000-0001-5737-6197

Notes

* Data in this manuscript were presented at the ID Week 2016 Conference in New Orleans, LA, USA (Oct. 26-30, 2016). Title: “Washington State Satellite HIV Clinic Program: Delivering Highly Effective Decentralized Care for Patients in Underserved Communities.” Abstract #499.

Additional information

Funding

The satellite HIV clinic system described here is supported by a contract with the Washington State Department of Health (contract #N21329).