扩大非美国出生的患者在联邦合格社区卫生中心的潜在结核病感染检测和治疗的规模
J Cochran1, A Tibbs2, H H Haptu3
1Massachusetts Department of Public Health, Boston, MA, USA. jennifer.cochran@mass.gov.
Journal of immigrant and minority health
|July 10, 2023
概括
公共卫生和社区卫生中心的合作伙伴关系使潜伏结核病感染 (LTBI) 测试增加了190%. 虽然15.5%的测试患者患有LTBI,但只有47.1%完成治疗,突出了护理缺口.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在美国消除结核病需要加强潜在结核病感染 (LTBI) 的诊断和治疗.
- 针对高风险发展为活跃结核病的个人至关重要.
- 医疗保健系统需要有效的策略来管理LTBI护理级联.
研究的目的:
- 评估公共卫生和社区卫生中心伙伴关系对LTBI诊断和治疗的影响.
- 评估在社区卫生中心的外国出生的患者中LTBI护理级联.
- 确定在LTBI管理中改善质量的关键领域.
主要方法:
- 修改电子健康记录以跟踪LTBI数据元素.
- 实施了一项公共卫生-社区卫生中心合作伙伴关系,用于LTBI护理.
- 对8827名在美国以外出生的患者进行了结核病感染查.
主要成果:
- 在外国出生的患者中,结核感染检测增加了超过190%.
- 1368名患者 (15.5%) 被诊断为LTBI.
- 确诊的LTBI患者中有47.1%的患者完成了治疗,在测试和评估 (24.3%) 和治疗建议和完成 (22.8%) 之间有显著的下降.
结论:
- 在初级保健医疗机构内嵌入结核病护理可以改善对高风险人群的以患者为中心的护理.
- 公共卫生和社区卫生中心之间的伙伴关系可以推动LTBI管理的质量提高.
- 在LTBI护理级联中存在显著的差距,特别是在诊断和治疗完成之间,需要有针对性的干预.
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