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Johns Hopkins AIDS Service

Index of articles from the Johns Hopkins AIDS Service

The Johns Hopkins AIDS Service logo
Patient Care -- Education -- Research

A Multi-Disciplinary Program
Dedicated to the Treatment and Prevention of HIV Infection


Historical Perspective

The Hopkins AIDS Care Program was initiated in January 1984 with the opening of the Moore Clinic for patients with HIV infection. The program has subsequently grown in numbers of patients and providers, and has now matured by the development of a full care network. It was organized in 1992 with the pro bono assistance of an executive (bank president) and a professor of business. The service was subsequently structured with the following service categories:


Services

The importance of this network of services within the Hopkins HIV/AIDS Program is that it represents an integrated system in which one group of providers manages patients through all components of the system. The Hopkins AIDS Care Service now has about 82 FTE (excluding physicians) or 142 FTE if the Osler 8 inpatient unit is included. Representatives of each group defined above are represented on an Executive Committee that meets on a regular basis to deal with issues of mutual interest and assure coordination of efforts. Each component has a mission statement, budget, program definition and description of goals and objectives. There were two retreats to facilitate integration of services and long term planning. This organizational structure became important for managed care planning because most of the network required to deliver care within an MCO was already developed. Other services that required development were a pharmacy benefit manager, transportation, and a home care program. The extensive network development was an important factor in persuading Johns Hopkins Health System to support the AIDS Service as a high priority for institutional support in managed care.


Patient Profile

A patient population of about 2,000 is served by the Hopkins HIV Care Service. Most are from Central Maryland and their demographics reflect the epidemic in Baltimore (Table 2). Demographics and risk categories show 76% of patients are African-American, 53% are injection drug users and 26% have an Axis-1 mental health disorder. The number with a CD4 cell count less than 200 is 38%. With regard to third party payor, 60% are Medicaid recipients, 34% are "no pay" and 6% have some form of commercial insurance. Approximately 5% of patients are homeless, but many more have no stable residence. There is a special hematology-infectious disease clinic for patients with hemophilia and HIV infection with a total enrollment of 22.

Table 2: Patients Served at the Moore Clinic
ActivityClinic census (CY 96)2,057
Number clinic visits (CY 96)14,995
No. new patients (CY 96)30/month
DemographicsSex: Male -- 68%; female -- 32%
Race: African-American -- 81%; Caucasian -- 19%
Risk: IDU -- 50%; gay male -- 18%
Payor source: Medicaid -- 60%; "no pay" -- 34%; Commercial: 23%


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