| Learning Objective #1: Identify the reasons that patients discontinue their primary care. | |||
| Learning Objective #2: Describe mechanisms to locate patients who are lost to care and get them back into care. |
Background/Purpose:
Over a four-year period our HIV Program utilized para-professional Client Advocates to locate and return over 900 patients formerly lost to care. The top ten reasons given by located clients for leaving care are examined to provide information to program planners to develop strategies and services that may address these barriers.
Methods/Practice:
Database was searched to find patients whose last primary care visit was greater than 12 months and the information given to the client advocates pursuing contact. Attempts were made via telephone, letter, certified letter and utilization of a field worker. Social Security and Bureau of Vital Statistics databases were searched as well. When a patient was located they were asked why they had chosen to leave care. Data was catalogued and reviewed.
Conclusions:
The top ten reasons given for leaving primary care were ranked and were as follows: patient feels well; unaware of appointments; work schedule; substance use; relocation; patient expired; incarceration; health insurance; transferred care to another facility; hospitalization.
Implications for Practice:
This study examines these reasons with discussion on the nature of the barriers, and implications for service delivery and program planning.