Mahendradhata Yodi
Center for Health Policy and Management, Faculty of Medicine, Gadjah Mada University, Sekip Utara, Yogyakarta, 55281, Indonesia.
Faculty of Medicine, Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
BMC Res Notes. 2015 Oct 23;8:600. doi: 10.1186/s13104-015-1586-x.
Tuberculosis case management practices of private practitioners in low- and middle-income countries are commonly not in compliance with treatment guidelines, thus increasing the risk of drug resistance. National Tuberculosis control programs have long been encouraged to collaborate with private providers to improve compliance, but there is no example yet of a sustained, large scale collaborations with private practitioners in these settings. Regulations have long been realized as a potential response to poor quality care, however there has been a lack of interest from the international actors to invest in stronger regulation of private providers in these countries due to limited evidence and many implementation challenges. Regulatory strategies have now evolved beyond the costly conventional form of command and control. These new strategies need to be tested for addressing the challenge of poor quality care among private providers. Multilateral and bilateral funding agencies committed to tuberculosis control need to invest in facilitating strengthening government's capacity to effectively regulate private providers.
低收入和中等收入国家私人执业医生的结核病病例管理做法通常不符合治疗指南，从而增加了耐药风险。长期以来，一直鼓励国家结核病控制项目与私人医疗服务提供者合作以提高依从性，但在这些环境中，尚未有与私人执业医生进行持续、大规模合作的范例。长期以来，监管一直被视为应对低质量医疗服务的一种潜在措施，然而，由于证据有限和诸多实施挑战，国际行为体缺乏对这些国家加强对私人医疗服务提供者监管的投资兴趣。监管策略现已超越了成本高昂的传统命令与控制形式。这些新策略需要进行测试，以应对私人医疗服务提供者低质量医疗服务的挑战。致力于结核病控制的多边和双边资助机构需要投资，以促进加强政府有效监管私人医疗服务提供者的能力。
