Issues in Implementing and Evaluating a Managed Care Home Health Care System for HIV/AIDS: Visiting Nurse Association Foundation of Los Angeles

Abstract

SUMMARY Blending curative and palliative orientations to care in the home care services delivery of terminal HIV/AIDS patients produces a cost efficient and patient effective overall model of care. This article characterizes the development, implementation, and evaluation of the Visiting Nurse Association Foundation of Los Angeles' (VNAF-LA) Transprofessional Model of terminal home care. Palliatively trained social workers were made part of the VNAF-LA's regular home care service delivery teams to create a biopsychosocial perspective to pre-hospice terminal care services. This enrollment to routine home care produced significant cost reductions and improved patients' quality of life. In addition, evaluation data were used to develop a cost profile of patient care.