Friends in Global Health (FGH), Maputo, Mozambique.
Department of Biostatistics, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America.
PLoS One. 2024 Apr 18;19(4):e0299282. doi: 10.1371/journal.pone.0299282. eCollection 2024.
Patient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique.
Monthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records. Regression analyses assessed the effect of satisfaction scores on retention and viral suppression, adjusting for age, sex, education, civil status, time on treatment, and site. Satisfaction scores were correlated with time spent at health facilities using generalized linear regression models.
Data from 4388 patients were analyzed. Overall median satisfaction score was 75% (IQR 53%-84%); median time spent at facilities (from arrival until completion of clinical services) was 2h54min (IQR 1h48min-4h). Overall satisfaction score was not associated with higher odds of retention or viral suppression, but association was seen between satisfaction regarding attention given to patient and respect and higher odds of viral suppression. Patient satisfaction was negatively associated with time spent in facility (Spearman's correlation -0.63). Increased time spent at facility (from 1 to 3 hours) was not associated with lower retention in care (OR 0.72 [95%CI:0.52-1.01] and 0.83 [95%CI: 0.63-1.09] at 6- and 12-months, respectively), nor with a lower odds of viral suppression (OR 0.96 [95%CI: 0.71-1.32]).
Strategies to reduce patient wait times at the health facility warrant continued prioritization. Differentiated models of care have helped considerably, but novel approaches are still needed to further decongest crowded health facilities. In addition, a good client-provider communication and positive attitude can improve patient satisfaction with health services, with an overall improved retention.
患者对临床服务的满意度会影响其在艾滋病毒护理中的保留率和对抗逆转录病毒治疗的依从性。本研究评估了赞比西亚省莫桑比克的患者满意度及其与保留率和病毒抑制的关联。
2017 年 8 月至 2019 年 1 月，在 20 个卫生机构每月对艾滋病毒感染者进行离职访谈；从病历中提取临床数据。回归分析评估了满意度评分对保留率和病毒抑制的影响，调整了年龄、性别、教育程度、婚姻状况、治疗时间和地点。使用广义线性回归模型，将满意度评分与在卫生机构花费的时间相关联。
对 4388 名患者的数据进行了分析。总体满意度中位数为 75%（IQR 53%-84%）；患者在机构（从到达至完成临床服务）花费的中位数时间为 2 小时 54 分钟（IQR 1 小时 48 分钟-4 小时）。总体满意度评分与保留率或病毒抑制率升高无关，但对患者关注和尊重的满意度评分与病毒抑制率升高有关。患者满意度与在机构中花费的时间呈负相关（Spearman 相关系数 -0.63）。在机构中花费的时间增加（从 1 小时增加到 3 小时）与护理保留率没有降低相关（分别在 6 个月和 12 个月时的比值比 0.72 [95%CI：0.52-1.01]和 0.83 [95%CI：0.63-1.09]），与病毒抑制率降低的可能性也没有降低（比值比 0.96 [95%CI：0.71-1.32]）。
减少患者在卫生机构等待时间的策略仍需持续优先考虑。有区别的护理模式已经有了很大的帮助，但仍需要新的方法来进一步缓解拥挤的卫生机构。此外，良好的医患沟通和积极的态度可以提高患者对卫生服务的满意度，从而整体提高保留率。
