ABSTRACT
In the United States and other developed countries, the cost of care for individual HIV-infected patients has fallen since shortly after the advent of modern antiretroviral therapy (ART) largely because of decreased rates of hospitalization and reduced hospital stays (1). The focus of care has moved increasingly into the outpatient setting. Almost simultaneously, managed care systems have proliferated in the United States, placing increased emphasis on standardization of treatment for chronic disease. Quality management as a discipline in health care has also come to the fore in recent years. The focus in this chapter will be on issues in quality management of the HIV-infected patient. Strategies to approach the diagnosis of HIV are included in chapter 1. Specific issues relevant to the elderly patients and to women are addressed in chapters 9 and 10, respectively. The final portion of this chapter is devoted to the unique issues confronted in resource-limited settings in establishing and measuring meaningful quality indicators.
