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  5. Performance Measure: Annual Retention in Care

Performance Measure: Annual Retention in Care

National Quality Forum #: None

Description: Percentage of patients, regardless of age, with a diagnosis of HIV who had at least two (2) encounters within the 12-month measurement year

Numerator: Number of patients in the denominator who had at least two1 HIV medical care encounters2 at least 90 days apart within a 12-month measurement year.

Denominator: Number of patients, regardless of age, with a diagnosis of HIV who had at least one HIV medical encounter within the 12-month measurement year

Patients Exclusions: Patients who died at any time during the measurement year

Data Elements:

  1. Does the patient, regardless of age, have a diagnosis of HIV? (Y/N)
    1. If yes, did the patient have at least two medical care encounters during the measurement year? (Y/N)
      1. If yes, did the patient have an HIV viral load test within the measurement year? (Y/N)
        • If yes, did the patient have at least one additional medical visit encounter with a provider with prescribing privileges within the measurement year? (Y/N)

          or
        • Did the patient have two medical visits with a provider with prescribing privileges within the measurement year? (Y/N)

National goals, target, or benchmarks for comparison

The annual Ryan White HIV/AIDS Services Report (RSR) captures national and state-level data regarding related measures such as HIV Viral Suppression and Annual Retention in Care. HRSA releases an RSR publication each year, which provides an in-depth look at demographics and socio-economic factors among clients served. Learn more about the RSR report and publication.

The Ryan White HIV/AIDS Program (RWHAP) Compass Dashboard displays aggregate-level RSR data and provides users an opportunity to interact with and visualize the reach, impact, and outcomes of the RWHAP. The RWHAP Compass Dashboard also visualizes information about RWHAP services received and characteristics of those clients accessing the AIDS Drug Assistance Program (ADAP).

In addition, the HIV Quality Measures (HIVQM) Module is a tool within the RSR portal that allows recipients to enter aggregate data specific to the HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Department of Health and Human Services Clinical Practice Guidelines

Adolescent/adult guidelines

"Retention in care should be routinely monitored. There are various ways to measure retention, including measures based on attended visits over a defined period of time (constancy measures), and measures based on missed visits. Both approaches are valid and independently predict survival. Missed visits and a prolonged time since last visit are relatively easy to measure and should trigger efforts to retain or re-engage a person in care. Constancy measures (e.g., at least two visits that are at least 90 days apart over 1 year, or at least one visit every 6 months over the last 2 years), can be used as clinic quality assurance measures."3

Pediatric guidelines

"Some general guidelines, mostly based on anecdotal evidence and consensus expert opinion, are available about transition plans and who might benefit most from them. To maximize the likelihood of success, providers should prepare adolescents for transition long before it occurs. Attention to the following key areas could improve retention in care and minimize the risk of ART interruptions... Clearly defining the desired outcomes for the transition, such as retention in care, ongoing access to other services (e.g., case management, mental health), clinical outcomes (e.g., viral suppression), and patient satisfaction ..."4

Use in other federal programs

This measure is linked to an exact or similar indicator(s) within the National HIV/AIDS Strategy (2022-2025).

References/notes

1 At least one of the two HIV medical care encounters needs to be a medical visit with a provider with prescribing privileges.

2 An HIV medical care encounter is a medical visit with a provider with prescribing privileges or an HIV viral load test.

3 Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (PDF - 4 MB). Department of Health and Human Services. Available online. Accessed August 2022. L-3.

4 Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed February 2023. H-7.

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