尼日利亚的可访问性和结核病患者满意度
M A Alatise1, P Narasimhan2, M D Gbadamosi3
1School of Population Health, University of New South Wales, Sydney, NSW, Australia;, Chest Clinic/TB Referral Centre, State Specialist Hospital, Osogbo, Osun, Nigeria;, Tuberculosis Control Unit, State Ministry of Health, Osogbo, Osun, Nigeria.
概括
与公共医疗机构相比,尼日利亚的私人医疗机构提供更容易获得和更令人满意的结核病治疗服务. 调查结果表明,将结核病服务分散到私人机构,以改善患者的体验和坚持.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 传染病流行病学 传染病流行病学
背景情况:
- 尼日利亚面临着全球高结核病 (TB) 负担,在非洲排名第一,全球排名第六.
- 药物敏感结核病 (DS-TB) 患者治疗不良的坚持有助于增加药物耐药性.
- 对结核病服务的审查至关重要,重点关注新建立的设施中的可访问性和患者体验.
研究的目的:
- 为了比较尼日利亚新建立的公共结核病治疗设施与私人结核病治疗设施的可访问性和患者报告的经验.
- 确定影响患者结核病服务体验的因素.
- 为改进结核病服务提供提供提供政策建议提供信息.
主要方法:
- 在尼日利亚的Osun进行了一项比较的横截面分析研究.
- 患者报告经验测量 (PREM) 问卷调查对430名患有DS-TB的患者进行了管理.
- 从27个公共设施和18个私人设施收集了数据,并使用R软件进行了分析.
主要成果:
- 与公共设施相比,私人设施的可访问性 (97.2%与90.7%) 和患者报告的满意度 (96.8%与90.7%) 显著提高.
- 在公共设施的患者中,更高的比例报告说无法承担运输费用 (52.6%与35.8%相比).
- 经过对共变量进行调整后,私人医院提供满意服务的几率高出3.12倍;医院类型,医院到医院的时间和婚姻状况是患者体验的重要预测因素.
结论:
- 在这个尼日利亚环境中,私人设施更容易获得,并且提供比公共设施更令人满意的结核病服务.
- 国家结核病计划应考虑去中心化结核病服务,以更有效地整合私人设施.
- 解决公共结核病设施中发现的差距对于改善整体服务提供和患者结果至关重要.
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