2021年埃塞俄比亚亚的斯亚贝巴部分公立医院的抗逆转录病毒治疗服务质量及相关因素

Antiretroviral Therapy Service Quality and Associated Factors at Selected Public Hospitals, Addis Ababa, Ethiopia, 2021.

作者信息

Tiruneh Chalachew Teshome, Woldeyohannes Fikirte Woldeselassie

机构信息

Department of Antiretroviral Treatment Unit, Zewditu Memorial Hospital, Addis Ababa, Ethiopia.

Department of Women, Children and Youth Director, Kotebe University of Education Menelik Ii Medical and Health Science College, Addis Ababa, Ethiopia.

出版信息

HIV AIDS (Auckl). 2022 Mar 25;14:129-142. doi: 10.2147/HIV.S348254. eCollection 2022.

DOI:10.2147/HIV.S348254

PMID:35370425

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8964440/

Abstract

BACKGROUND

It is important to offer high-quality HIV/AIDS treatment and antiretroviral medication to people living with the disease to improve health outcomes. The quality of health services has become a public health issue.

OBJECTIVE

To assess ART service quality and associated factors at a selected public hospital, Addis Ababa, Ethiopia, in 2021.

METHODS

A mixed study design was used from April to May 2021. Donabedian's structure-process-outcome model of health care quality was employed as a framework. A total of 420 clients were interviewed to obtain quantitative data, and 08 key informant interviews and 357 program documents were reviewed. Quantitative data were checked, coded, and entered into Epi Info version 7.2 and exported into SPSS windows version 25.0. In the multivariable logistic regression analysis, variables with p-values < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify factors associated with client satisfaction. Qualitative data were transcribed and analysed using the ATLAS.ti version 8 software program and used to complement the quantitative findings.

RESULTS

The overall quality of ART services was 73.3% for the availability of resources, 79.5% for healthcare providers' compliance with the national guidelines, and 86.4% for client satisfaction with the quality of ART clinical services. Patients who disclosed their HIV status [AOR 10.7, 95% CI: 5.2-22], months of ART [AOR 10.4, 95% CI: 3.89-27.8], age group 34-44, 45-55, and 56-76 years were found to be 5.1, 8.1, and 5 [AOR 5.1,95% CI:1.2-22, AOR 8.1,95% CI:1.9-35.5, AOR 5,95% CI:2.97-9.44], respectively, and consultation time [AOR 3.5, 95% CI: 1.6-7.35] were associated with client satisfaction on the quality of ART clinical services.

CONCLUSION

This study revealed that the overall quality of ART services in selected Addis Ababa public hospitals was good, although with the availability of resources and compliance health care providers need improvement.

摘要

背景

为艾滋病病毒/艾滋病患者提供高质量的治疗和抗逆转录病毒药物对于改善健康状况至关重要。卫生服务质量已成为一个公共卫生问题。

目的

评估2021年埃塞俄比亚亚的斯亚贝巴一家选定公立医院的抗逆转录病毒治疗（ART）服务质量及相关因素。

方法

于2021年4月至5月采用混合研究设计。采用Donabedian的医疗保健质量结构-过程-结果模型作为框架。共对420名患者进行访谈以获取定量数据，并对8次关键 informant 访谈和357份项目文件进行了审查。定量数据经过检查、编码后录入Epi Info 7.2版本，并导出到SPSS 25.0窗口版本中。在多变量逻辑回归分析中，p值<0.05且调整后的优势比（AOR）及95%置信区间（CI）的变量用于确定与患者满意度相关的因素。定性数据使用ATLAS.ti 8软件程序进行转录和分析，并用于补充定量研究结果。

结果

抗逆转录病毒治疗服务的总体质量方面，资源可用性为73.3%，医护人员对国家指南的依从性为79.5%，患者对抗逆转录病毒治疗临床服务质量的满意度为86.4%。披露其艾滋病病毒感染状况的患者[AOR 10.7，95% CI：5.2 - 22]、接受抗逆转录病毒治疗的月数[AOR 10.4，95% CI：3.89 - 27.8]、年龄组34 - 44岁、45 - 55岁和56 - 76岁的患者分别为5.1、8.1和5倍[AOR 5.1，95% CI：1.2 - 22，AOR 8.1，95% CI：1.9 - 35.5，AOR 5，95% CI：2.97 - 9.44]，以及咨询时间[AOR 3.5，95% CI：1.6 - 7.35]与患者对抗逆转录病毒治疗临床服务质量的满意度相关。