The Effect of Care Team Composition on the Quality of HIV Care

Multidisciplinary teams of health care providers including generalists, specialists and nurse practitioners may provide a better quality of care to patients with chronic health conditions than single-physician care, although little research has been carried out to compare the two approaches. In this study, the authors use data from the HIV Cost Services Utilization Study, a longitudinal study of 2,864 non-hospitalized HIV-infected persons in the United States, to assess the effect of different care team compositions on quality of care.

Key Findings:

  • HIV care teams with three or more clinicians more consistently prescribe pneumocystis carinii pneumonia prophylaxis and pap smears than single-physician care but not highly active antiretroviral therapy.
  • Patients with single-physician care are less likely to have an inappropriate emergency department visit than those with multidisciplinary care teams.
  • Patients with many clinicians in their care team report more coordination problems, less satisfaction with their care and lower trust in their providers compared with those under one physician.

These results suggest that having multiple clinicians can have both advantages and disadvantages for patients, and that the effect of composition on quality of care may depend on the complexity of the clinical task.