| Landon 2005 (18) | USA | Prospective cohort study. Data collected for years 2000-2005 | HIV patients age 18+ in federally funded HIV clinics (community health centers, community-based organisations, health departments, hospital outpatient clinics, university medical centers) (n = 5247). | ID physicians vs. (HIV-expert) GM physicians vs. (non-HIV-expert) GM physicians | ID physician | HIV-expert | Non-HIV-expert | After controlling for specialty training, caseload and knowledge, non-HIV-expert GM’s overall quality of care is lower than ID physicians and HIV-expert GM (adj P = 0.02). Caseload differences not statistically significant. All data were adjusted for patients’ characteristics. | ||||
| cART therapy | ID physicians and HIV-expert GM vs. non-HIV-expert GM, 80% vs. 73% (P < 0.001) | |||||||||||
| VL control | ID physicians (41%) vs. HIV-expert GM (39%) vs. non-HIV-expert GM (31%) (P = 0.01) | |||||||||||
| Flu vaccination rate | ID physicians (54%) vs. HIV-expert GM (49%) vs. non-HIV-expert GM (41%) (P < 0.01) | |||||||||||
| PJP, PPD, HCV, Pap smear | No statistical significant difference | |||||||||||
| Outpatient visit | ID physicians (66%) vs. HIV-expert generalists (69%) vs. non-HIV-expert generalists (57%) (P < 0.01) | |||||||||||
| Page 2003 (17) | Zurich, Switzerland | Prospective cohort study. Data collected for years 1999-2001 | HIV patients on ART receiving care in an urban area in general practices vs. a specialized university o utpatient clinic (n = 106) | GP vs. ID specialists vs. shared care between GP and ID specialists. | GP | ID | Shared care | Significance | *= Data measured at baseline only. No adjustment was made because patients in all healthcare provider groups had similar baseline characteristics. | |||
| Median CD4 count | 459 cells/µl (range: 120 - 1442) | 449 cells/µl (79 - 891) | 303.5 cells/µl (104 - 751) | No | ||||||||
| % of patients with VL < 400 copies/ml | 72.1% | 74.2% | 87.5% | No | ||||||||
| Mean quality of life of all participants | 129.5 ± 22.5 baseline, 131.6 ± 25.6 at study end | No | ||||||||||
| Mean patient satisfaction* | Patients with GP and shared care are more satisfied than those with ID specialists | P < 0.05 | ||||||||||
| ART use | No statistical significant difference | |||||||||||
| Patient’s evaluation of providers | GP received statistically significantly higher mean scores for many dimensions of care (such as competence, information, communication, time and trust) than ID specialists. | |||||||||||
| Mean rate of ART adherence | No statistical significant difference | |||||||||||
| Schneider 2008 (19) | USA | Prospective cohort study. Data collected for years 2001-2003 | HIV patients admitted to a general medicine, non-critical care inpatient services in six institutions (n = 1207). | Hospitalists (spend at least 25% of time in GM services) vs. non-hospitalists (spend less than 25% of time in GM services). | Hospitalist | Non-hospitalist | Readmission rates, emergency department visits and health status were self-reported. No clear descriptions of hospitalists and non-hospitalists besides the amount of time they spend in GM inpatient care. All data were adjusted for patients’ characteristics, physicians’ experience, care sites and time of hospital admission. | |||||
| In-hospital mortality rate | adj P = 0.38 | |||||||||||
| 6-month mortality rate | adj P = 0.57 | |||||||||||
| 30-day readmission rate | adj P = 0.99 | |||||||||||
| 30-day emergency department visit rate | adj P = 0.70 | |||||||||||
| 30-day reported health | adj P = 0.97 | |||||||||||
| Overall patient satisfaction | adj P = 0.98 | |||||||||||