Human Immunodeficiency Virus–Experienced Clinician Workforce Capacity: Urban–Rural Disparities in the Southern United States
| العنوان: | Human Immunodeficiency Virus–Experienced Clinician Workforce Capacity: Urban–Rural Disparities in the Southern United States |
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| المؤلفون: | Daniel E. Nixon, Lauren Yerkes, Bassam Dahman, Anne Rhodes, Lindsay M. Sabik, April D. Kimmel, Faye Z. Belgrave, Rose S Bono, Yangyang Deng |
| المصدر: | Clin Infect Dis |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Rural Population, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Urban Population, Human immunodeficiency virus (HIV), HIV Infections, Hiv management, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Rurality, Interquartile range, medicine, Humans, 030212 general & internal medicine, Health statistics, Medicaid, business.industry, HIV, virus diseases, 030112 virology, Care Continuum, United States, Major Articles and Commentaries, Infectious Diseases, Family medicine, Workforce, business |
| الوصف: | Background Human immunodeficiency virus (HIV)–experienced clinicians are critical for positive outcomes along the HIV care continuum. However, access to HIV-experienced clinicians may be limited, particularly in nonmetropolitan areas, where HIV is increasing. We examined HIV clinician workforce capacity, focusing on HIV experience and urban–rural differences, in the Southern United States. Methods We used Medicaid claims and clinician characteristics (Medicaid Analytic eXtract [MAX] and MAX Provider Characteristics, 2009–2011), county-level rurality (National Center for Health Statistics, 2013), and diagnosed HIV cases (AIDSVu, 2014) to assess HIV clinician capacity in 14 states. We assumed that clinicians accepting Medicaid approximated the region’s HIV workforce, since three-quarters of clinicians accept Medicaid insurance. HIV-experienced clinicians were defined as those providing care to ≥ 10 Medicaid enrollees over 3 years. We assessed HIV workforce capacity with county-level clinician-to-population ratios, using Wilcoxon-Mann-Whitney tests to compare urban–rural differences. Results We identified 5012 clinicians providing routine HIV management, of whom 28% were HIV-experienced. HIV-experienced clinicians were more likely to specialize in infectious diseases (48% vs 6%, P Conclusions Significant urban–rural disparities exist in HIV-experienced workforce capacity for communities in the Southern United States. Policies to improve equity in access to HIV-experienced clinical care for both urban and rural communities are urgently needed. |
| تدمد: | 1537-6591 1058-4838 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0b5cceec5e915b0361af78fc489a37f5 https://doi.org/10.1093/cid/ciaa300 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....0b5cceec5e915b0361af78fc489a37f5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
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