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患者对埃塞俄比亚西北部贡德尔镇卫生中心抗逆转录病毒治疗服务的满意度及其相关因素:一项基于机构的横断面研究。

Patient satisfaction with antiretroviral therapy services and associated factors at Gondar town health centers, Northwest Ethiopia: an institution-based cross-sectional study.

机构信息

Federal Democratic Republic of Ethiopia, Pharmaceuticals Fund and Supply Agency, Addis Ababa, Ethiopia.

Department of Health System and Policy, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Health Serv Res. 2020 Feb 6;20(1):93. doi: 10.1186/s12913-020-4934-z.

Abstract

BACKGROUND

The Human Immunodeficiency Virus (HIV) with which over 37 million peoples are living is the leading cause of morbidity and mortality worldwide. The rapid expansion of antiretroviral treatment has dramatically reduced HIV related deaths and transmissions. Patient satisfaction could be an indispensable parameter used to measure patients' desired fulfillment by the services. Hence, this study aimed to determine the level of patient satisfaction with antiretroviral therapy services and determinants at Gondar town health centers.

METHODS

An institution-based cross-sectional study was conducted from November 1 to 30, 2018. The systematic random sampling technique was used to select 663 HIV/AIDS patients on antiretroviral therapy follow-ups. Data were collected using a pretested interviewer-administered questionnaire and patient medical document reviews. Summary statistics such as means, medians and proportions were calculated and presented in the form of tables, graphs, and texts. Bivariate and multivariable logistic regression analysis was fitted and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to assess the strength of association. Variables with p-value 0.05 at multivariable logistic regression considered significant determinants of patient satisfaction.

RESULTS

The overall patient satisfaction with antiretroviral therapy services was 75.4% (95%CI, 71.9 to 79%). Patients' age 38-47 years (AOR = 5.90, 95%CI: 3.38,10.31) and ≥ 48 years (AOR = 2.66, 95%CI:1.38,5.12), absence of signs and directions to ART clinic (AOR = 0.53,95%CI:0.35,0.82), Azezo health center (AOR = 2.68,95%CI:1.47,4.66) and Teda health center (AOR = 4.44,95%CI:1.73,11.30), and travel that took more than 1 h (AOR = 0.56;95% CI:0.32,0.97) were determinants of patient satisfaction with the services.

CONCLUSION

The overall patient satisfaction with antiretroviral therapy service was lower than the national target of 85% with the marked difference among health centers. Older age, absence of signs and directions to ART clinics, and longer travel from home to health centers were factors influencing patient satisfaction with antiretroviral treatments. This suggests that further improvement of accessibility is likely needed to increase patient satisfaction.

摘要

背景

人类免疫缺陷病毒(HIV)感染超过 3700 万人,是全球发病率和死亡率的主要原因。抗逆转录病毒治疗的迅速扩展极大地降低了与 HIV 相关的死亡和传播。患者满意度可以作为衡量患者对服务需求满足程度的不可或缺的参数。因此,本研究旨在确定贡德尔镇卫生中心接受抗逆转录病毒治疗的患者对该服务的满意度水平及其决定因素。

方法

这是一项 2018 年 11 月 1 日至 30 日进行的基于机构的横断面研究。采用系统随机抽样技术,选择 663 名接受抗逆转录病毒治疗随访的艾滋病毒/艾滋病患者。使用经过预测试的访谈者管理的问卷和患者医疗文件审查来收集数据。计算了均值、中位数和比例等汇总统计数据,并以表格、图形和文本的形式呈现。进行了单变量和多变量逻辑回归分析,并计算了调整后的比值比(AOR)和 95%置信区间(CI),以评估关联的强度。在多变量逻辑回归中,p 值 0.05 的变量被认为是患者满意度的显著决定因素。

结果

抗逆转录病毒治疗服务的总体患者满意度为 75.4%(95%CI,71.9-79%)。患者年龄 38-47 岁(AOR=5.90,95%CI:3.38-10.31)和≥48 岁(AOR=2.66,95%CI:1.38-5.12)、缺乏前往抗逆转录病毒治疗诊所的指示和标志(AOR=0.53,95%CI:0.35-0.82)、Azezo 卫生中心(AOR=2.68,95%CI:1.47-4.66)和 Teda 卫生中心(AOR=4.44,95%CI:1.73-11.30)以及需要 1 小时以上的旅行(AOR=0.56;95%CI:0.32-0.97)是影响患者对服务满意度的决定因素。

结论

抗逆转录病毒治疗服务的总体患者满意度低于全国 85%的目标,各卫生中心之间存在显著差异。年龄较大、缺乏前往抗逆转录病毒治疗诊所的指示和标志以及从家到卫生中心的旅行时间较长是影响患者对抗逆转录病毒治疗满意度的因素。这表明,可能需要进一步改善可及性,以提高患者的满意度。

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