THE SEATTLE APPROPRIATE LEVEL OF CARE SURVEY - HEALTH-STATUS AND HEALTH-SERVICES USE IN AMBULATORY PERSONS WITH AIDS

We surveyed 77 persons with AIDS, their physicians and their social workers during the autumn of 1987 to ascertain health status and to quantify use of health services in Seattle, Washington. Participants included the majority (59%) of persons living with AIDS in the area. Information was gathered regarding demography, health status, functional status, medical history and the use of health services. The validity of self-assessed general health was corroborated by the physician-rated Karnovsky score (kappa = 0.59), by social worker assessment (kappa = 0.41), and by correlation with functional status (r = 0.6-0.8). We found more frequent use of health services (categorized into skilled services, chore services and physician services) among AIDS patients who were dependent in basic and instrumental daily activities, had low income, had poor self-assessed general health, lived alone or lacked an available support person at home. These associations persisted in multivariate analyses, and accounted for 6-23% of the variability in service use. We conclude that health and functional status of persons with AIDS can be estimated via mailed questionnaires and accounts for a modest amount of the variability in use of health services.