卢旺达农村非传染性疾病诊所中慢性肿瘤服务的整合。

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda.

机构信息

College of Medicine and Health Sciences, University of Rwanda, Kigali, RW.

Ministry of Health, Kigali, RW.

出版信息

Ann Glob Health. 2020 Mar 23;86(1):33. doi: 10.5334/aogh.2697.

DOI:10.5334/aogh.2697

PMID:32257833

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7101006/

Abstract

BACKGROUND

In rural sub-Saharan Africa, access to care for severe non-communicable diseases (NCDs) is limited due to myriad delivery challenges. We describe the implementation, patient characteristics, and retention rate of an integrated NCD clinic inclusive of cancer services at a district hospital in rural Rwanda.

METHODS

In 2006, the Rwandan Ministry of Health at Rwinkwavu District Hospital (RDH) and Partners In Health established an integrated NCD clinic focused on nurse-led care of severe NCDs, within a single delivery platform. Implementation modifications were made in 2011 to include cancer services. For this descriptive study, we abstracted medical record data for 15 months after first clinic visit for all patients who enrolled in the NCD clinic between 1 July 2012 and 30 June 2014. We report descriptive statistics of patient characteristics and retention.

RESULTS

Three hundred forty-seven patients enrolled during the study period: oncology - 71.8%, hypertension - 10.4%, heart failure - 11.0%, diabetes - 5.5%, and chronic respiratory disease (CRD) - 1.4%. Twelve-month retention rates were: oncology - 81.6%, CRD - 60.0%, hypertension - 75.0%, diabetes - 73.7%, and heart failure - 47.4%.

CONCLUSIONS

The integrated NCD clinic filled a gap in accessible care for severe NCDs, including cancer, at rural district hospitals. This novel approach has illustrated good retention rates.

摘要

背景

在撒哈拉以南非洲农村地区，由于众多的交付挑战，严重非传染性疾病（NCD）的护理服务难以获得。我们描述了在卢旺达农村地区的 Rwinkwavu 区医院，实施包括癌症服务在内的综合 NCD 诊所的情况，包括实施情况、患者特征和保留率。

方法

2006 年，卢旺达卫生部在 Rwinkwavu 区医院（RDH）和健康伙伴组织建立了一个综合 NCD 诊所，该诊所专注于严重 NCD 的护士主导护理，采用单一的交付平台。2011 年进行了实施修改，包括癌症服务。在这项描述性研究中，我们为 2012 年 7 月 1 日至 2014 年 6 月 30 日期间首次就诊后在 NCD 诊所登记的所有患者，从病历中提取了 15 个月的数据。我们报告了患者特征和保留情况的描述性统计数据。

结果

在研究期间，有 347 名患者登记：肿瘤学 - 71.8%，高血压 - 10.4%，心力衰竭 - 11.0%，糖尿病 - 5.5%，慢性呼吸道疾病（CRD） - 1.4%。12 个月的保留率分别为：肿瘤学 - 81.6%，CRD - 60.0%，高血压 - 75.0%，糖尿病 - 73.7%，心力衰竭 - 47.4%。