these data sources represent information that is collected and reported in a standardized manner, is publicly available, provided at the county level, and is routinely updated. The U.S. Census is only conducted every 10 years. The Current Population Survey is conducted monthly and updated estimates are provided annually, although those data are not available at the county level. The ARF data are updated annually.

HCSUS interviewed a total of 2,864 patients. Using the location information gathered in interviews, it was possible to attach a zip code to 2,360 of these patients and link information from their interviews to information from the February 1996 ARF (Landon et al., 2002). This ARF was chosen because it corresponds to the time when the patients were interviewed for the HCSUS. These 2,360 patients resided in 82 counties with a mean count of 29 patients per county (ranging from 1 to 260). A total of 504 patients were not linked because of a missing or unmatched zip code either in the HCSUS sample or in the ARF file.


As examples of indicators of need, the Committee created two dependent variables using data from the HCSUS study. The first variable measured the number of needs reported by the patients. In the HCSUS interview, each patient was asked the following questions:

  1. Did you need income assistance such as SSI, SSDI, AFDC, or health care benefits from Medicaid or the Veterans Administration in the last 6 months?

  2. Did you need to find a place to live in the last 6 months?

  3. Did you need home health care in the last 6 months?

  4. Did you need mental health or emotional care or counseling in the last 6 months?

  5. Did you need drug or alcohol treatment in the last 6 months?

The Committee created a variable called “number of needs,” which is simply the number of these questions that the respondent answered affirmatively.

The HCSUS interview also asked whether patients had received highly active antiretrovial therapy (HAART). Although this is not a direct indicator of resource needs, differences in use of appropriate therapies might be an indicator of variations in resources and/or difficulties treating patients appropriately. The working definition of HAART use, which is based on the Department of Health and Human Services/Henry J. Kaiser Foundation definition used in the Guidelines for the Use of Antiretroviral Agents in HIV Infected Adults and Adolescents, was: taking

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