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H H S Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Programs

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Severity of Need (SON) Index - Recommendations

The draft SON Index was developed from multiple sources: deliberations and recommendations of the Panels; input and consensus from advising bodies (HRSA Implementation Workgroup and Collaboration Council) and recommendations in a series of supplemental studies conducted to explore data issues in greater detail. The below chart summarizes recommendations from all these sources and is followed by a more detailed discussion of recommendations from these sources.

Measures to Include in SON Index

Observations from the April 2006 Panel Meeting

Areas with Stronger Data:
  • Case counts
  • Total cases
  • Prevalence rates
  • Deaths among patients from all causes
  • Demographics characteristics of infected patients
  • Exposure category of infected patients
  • Area characteristics
  • Poverty
  • Differences in medical labor costs
  • Population level lack of insurance
  • Access to/lack of access to medical providers
Areas with Weaker Data:
  • Socioeconomic characteristics of patients
  • Patient poverty
  • Patient insurance status
  • Patient immigration status
  • Patient homelessness
  • Clinical characteristics of patients
  • Disease stage/progression
  • Crack cocaine, and non-injecting methamphetamine abuse
  • Mental illness
Strong Ability to Adjust For:
  • Burden of disease
  • Aggregate case counts
  • Rates of disease
  • Area differences in overall medical costs
  • Area differences in poverty
  • Area differences in overall access to care
  • IDU exposure category
More Challenging to Adjust For:
  • Differences in patient clinical stage of disease
  • Differences in patient socioeconomic status
  • Level of unmet need
  • Medicaid enrollment
  • Medicaid adequacy