Lestari B W, Alifia A, Soekotjo F N, Sumantri A F, Kulsum I D, Alisjahbana B
Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Tuberculosis Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Public Health Action. 2023 Jun 21;13(2):37-42. doi: 10.5588/pha.23.0056.
The COVID-19 pandemic has caused disruptions to healthcare services worldwide, including in private healthcare facilities (HCFs), where TB patients mostly initiate their care-seeking journey.
To identify adjustments to TB-related practices made by HCFs during the pandemic.
We identified, contacted and invited private HCFs across West Java, Indonesia, to fill an online questionnaire. The questionnaire explored participants' sociodemographic characteristics, adaptations and TB management practices implemented in their facilities during the pandemic. Data were analysed using descriptive statistics.
Of the 240 HCFs surveyed, 40.0% shortened their operational hours and 21.3% have ever closed their practices during the pandemic; 217 (90.4%) made adjustments to keep delivering services, 77.9% by requiring the use of personal protective equipment (PPE); 137 (57.1%) observed fewer patient visits; 140 (58.3%) used telemedicine, a few of which (7.9%) ever handled TB patients on that platform. Respectively 89.5%, 87.5% and 73.3% of HCFs referred patients for chest radiography, smear microscopy and Xpert testing. Only a median of 1 (IQR 1-3) TB patient per month was diagnosed by the HCFs.
Two major adaptations rolled out during COVID-19 were the use of telemedicine and PPE. Optimisation of the diagnostic referral system to increase TB case detection in private HCFs is warranted.
新冠疫情已对全球医疗服务造成干扰，包括在私立医疗机构，结核病患者大多在此开启其寻求治疗之旅。
确定私立医疗机构在疫情期间对结核病相关诊疗措施所做的调整。
我们在印度尼西亚西爪哇识别、联系并邀请私立医疗机构填写一份在线问卷。该问卷探究了参与者的社会人口学特征、调整措施以及疫情期间其机构实施的结核病管理措施。使用描述性统计方法分析数据。
在接受调查的240家私立医疗机构中，40.0%缩短了营业时间，21.3%在疫情期间曾暂停营业；217家（90.4%）进行了调整以继续提供服务，77.9%是通过要求使用个人防护装备（PPE）；137家（57.1%）的就诊患者减少；140家（58.3%）使用了远程医疗，其中少数（7.9%）曾在该平台处理过结核病患者。分别有89.5%、87.5%和73.3%的私立医疗机构将患者转诊进行胸部X光检查、涂片显微镜检查和Xpert检测。私立医疗机构每月诊断的结核病患者中位数仅为1例（四分位间距1 - 3）。
新冠疫情期间实施的两项主要调整措施是使用远程医疗和个人防护装备。有必要优化诊断转诊系统以提高私立医疗机构的结核病病例发现率。
