Operational research principles for a routine service process for monitoring the human immunodeficiency virus/acquired immunodeficiency syndrome treatment cascade: data from a cohort in Brazil

Abstract INTRODUCTION: Bottlenecks still exist during human immunodeficiency virus care that may delay the achievement of better outcomes. METHODS: We established a monitoring system to trace patients throughout the human immunodeficiency virus/acquired immunodeficiency syndrome care process in Juiz de Fora, Brazil, to identify potential bottlenecks. RESULTS: Among 250 patients, 17.6% abandoned follow-up. Our monitoring system tracked 86.4% of patients through the medication logistics control system and 2.3% through the mortality information system. Two percent of patients were not located by our monitoring system. CONCLUSIONS: A pathway care process contributes to a better understanding of the barriers to the treatment cascade.