Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act

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The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV.

In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.

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Editorial Reviews

Doody's Review Service
Reviewer: Anton M Somlai, Ed.D.(Medical College of Wisconsin)
Description: The Institute of Medicine (IOM) was commissioned by HRSA and the Centers for Disease Control and Prevention (CDC) to conduct a study in response to a congressional mandate in the Ryan White CARE Act Amendments of 2000. The charge was to: (1) assess whether reported HIV cases were adequate, reliable, and sufficiently accurate in formula grants; (2) identify data and tools for assessing a community's severity of need for allocation decisions; and (3) identify available health outcomes and other data that can be used to measure the quality of and access to RWCA-funded services.
Purpose: The purpose of the book was to describe the committee recommendations in addressing how HIV data can be used in Title I and II allocation formulas, describing what information was needed to estimate the severity of need for resources, and developing recommendations for quality-of-care measures. The book is needed because inequities in reporting HIV cases significantly affects the resources that states will have available in addressing the HIV/AIDS epidemic. The book does an excellent and thorough job in providing recommendations that specifically address Congressional mandates for RWCA.
Audience: This book is intended for individuals involved with health care policy, community planning, community health systems, health sciences, front-line providers, and health prevention/disease prevention researchers. Additionally, the book addresses congressional concern regarding fund allocation and would be of benefit to key decision makers in AIDS care funding.
Features: The book addresses potential inequalities in health care across the four major program titles (I-IV) in the Ryan White Act. The strength of the book is in how it addresses the problems regarding equitability of allocations across states and providers of services. Given an extremely complex charge, the book is highly fluid and responsive in providing recommendations that will impact future resources.
Assessment: This book is extremely important given limited resources in governmental funding of prevention initiatives. The findings and recommendations are a benchmark for estimating resource needs by a complex array of factors, including disease burden, the cost of providing care, and available resources.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780309091152
  • Publisher: National Academies Press
  • Publication date: 6/15/2004
  • Pages: 320
  • Product dimensions: 6.00 (w) x 8.90 (h) x 0.80 (d)

Table of Contents

1 Introduction 27
2 Overview of the HIV/AIDS epidemic and the Ryan White Care Act 41
3 Public health and HIV/AIDS surveillance 73
4 HIV reporting data and Title and II formulas 87
5 Estimating resource needs 135
6 Measuring quality of care 188
7 Findings and recommendations 221
App Financial resources of states for HIV/AIDS reporting 239
App Analyses of the sensitivity of the formula allocations to underlying changes in input data 247
App Methodological details of HCSUS analyses 261
App Tables of HIV/AIDS quality measures from selected sources 267
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