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印度希萨尔私立医生对结核病诊断流程中“患者至上”理念的看法

Private Doctors' Perspective towards "Patient First" in TB Diagnostic Cascade, Hisar, India.

作者信息

Saini Sanjeev, Prasad Banuru Muralidhara, Mahajan Ajay, Duhan Akshay, Jangra Anuj, Gauttam Jitendra, Malik Mandeep, Kayesth Jyoti, Vadera Bhavin, Hobson Reeti Desai

机构信息

Infectious Disease Detection and Surveillance (IDDS), ICF, New Delhi 110037, India.

State Indian Medical Association, Hisar 125001, Haryana, India.

出版信息

Diagnostics (Basel). 2024 May 31;14(11):1164. doi: 10.3390/diagnostics14111164.

Abstract

TB diagnosis has been simplified in India following advances in available diagnostic tools. This facilitates private doctors' "patient first" approach toward early diagnosis; however, costs remain high. India's NTEP established a TB diagnostic network, which is free for patients and incentivizes private doctors to participate. Drawing from this context led to the design and implementation of the One-Stop TB Diagnostic Solution model, which was conducted in the Hisar district, Haryana, allowing specimens from presumptive TB patients from private doctors to be collected and tested as per NTEPs diagnostic algorithm. A subset of data pertaining to private doctors was analyzed for the project period. Qualitative data were also collected by interviewing doctors using a snowball method to capture doctors' perception about the model. Out of 1159 specimens collected from 60 facilities, MTB was detected in 32% and rifampicin resistance was detected in 7% specimens. All specimens went through the diagnostic algorithm. Thirty doctors interviewed were satisfied with the services offered and were appreciative of the program that implements this "patient centric" model. Results from implementation indicate the need to strengthen private diagnostics through a certification process to ensure provision of quality TB diagnostic services.

摘要

随着现有诊断工具的进步,印度的结核病诊断已得到简化。这促进了私人医生对早期诊断采取“患者至上”的方法;然而,成本仍然很高。印度的国家结核病控制项目(NTEP)建立了一个结核病诊断网络,该网络对患者免费,并激励私人医生参与。在此背景下,设计并实施了一站式结核病诊断解决方案模型,该模型在哈里亚纳邦希萨尔区开展,允许按照NTEP的诊断算法收集和检测来自私人医生处疑似结核病患者的样本。对项目期间与私人医生相关的一部分数据进行了分析。还通过滚雪球抽样法采访医生收集定性数据,以了解医生对该模型的看法。从60个机构收集的1159份样本中,32%检测出结核分枝杆菌(MTB),7%的样本检测出利福平耐药。所有样本都经过了诊断算法。接受采访的30名医生对所提供的服务感到满意,并对实施这种“以患者为中心”模式的项目表示赞赏。实施结果表明,需要通过认证程序加强私人诊断,以确保提供高质量的结核病诊断服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/11171542/49b44e893d23/diagnostics-14-01164-g001.jpg

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