Philip Todd Korthuis, Kathleen A. McGinnis, Kevin L. Kraemer, Adam J. Gordon, Melissa Skanderson, Amy C. Justice, Stephen Crystal, Matthew Bidwell Goetz, Cynthia L. Gibert, David Rimland, Lynn E. Fiellin, Julie R. Gaither, Karen Wang, Steven M. Asch, Donald Keith McInnes, Michael E. Ohl, Kendall Bryant, Janet P. Tate, Mona Duggal, David A. Fiellin

 The Patient Protection and Affordable Care Act encourages healthcare systems to track quality of care (QOC) measures; little is known about their impact on mortality. The objective was to assess associations between HIV QOC and mortality.  Longitudinal survival analysis of the Veterans Aging Cohort Study. 3,038 HIV-infected patients enrolled between June 2002 and July 200. The independent variable was receipt of≥80% of nine HIV quality indicators (QIs) abstracted from medical records in the 12 months after enrollment. Overall mortality through 2014 was assessed from VHA, Medicare, and Social Security National Death Index records. We assessed associations between receiving≥80% of HIV QIs and mortality using Kaplan Meier survival analysis and adjusted Cox proportional hazards models. Results were stratified by unhealthy alcohol and illicit drug use.  The majority of participants were male (97.5%) and Black (66.8%), with mean age of 49.0 (standard deviation [SD] 8.8) years. Overall, 29.5% reported past year unhealthy alcohol use and 28.4% reported past year illicit drug use. During 24,805 person-years (PY) of follow-up (mean 8.2, SD 3.3 years), those who received≥80% of QIs experienced lower age-adjusted mortality (adjusted hazard ratio=0.75, 95% CI 0.65-0.86). Adjustment for disease severity attenuated the association.  Receipt of≥80% of select HIV QIs is associated with improved survival in a sample of predominantly male, Black, HIV-infected patients but were insufficient to overcome adjustment for disease severity. Interventions to ensure high QOC and address underlying chronic illness may improve survival in HIV-infected patients.