Lazo-Porras Maria, Tateishi-Serruto Francisco Jose, Butler Christopher, Cuba-Fuentes María Sofía, Rossini-Vilchez Daniela, Perez-Leon Silvana, Lúcar-Flores Miriam, Miranda J Jaime, Bernabe-Ortiz Antonio, Diez-Canseco Francisco, Moore Graham, Landeiro Filipa, Cardenas Maria Kathia, Vera Tudela Juan Carlos, White Lee, Calvo Rafael A, Whiteley William, Hawkins Jemma
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Department of Brain Sciences, Imperial College London, London, United Kingdom.
JMIR Res Protoc. 2025 Mar 21;14:e60296. doi: 10.2196/60296.
Dementia is a global health priority with significant challenges due to its complex nature and increasing prevalence. Health systems worldwide struggle to address chronic conditions like dementia, often providing fragmented care. However, information about how health systems respond to the needs of people with dementia and their carers, and the quality of care provided, is scarce in low- and middle-income countries.
This study aims to assess the quality of the health system to provide diagnosis and care for people with dementia and their carers in Peru. In order to do this, the study will explore the response of the Peruvian health system to people with dementia and their carers, and explore the experiences of people with dementia of receiving their diagnosis, management, and quality of care for this condition.
This study is part of a research program called "IMPACT Salud: Innovations using Mhealth for people with dementia and Co-morbidities," aimed at strengthening health systems to provide care for people with dementia and their carers. The study has a descriptive, cross-sectional design that uses a qualitative methodology, including stakeholder interviews and documentation review, and consists of 2 substudies, a health system assessment (HSA) and an exploration of the patient journey. The first substudy uses an HSA methodology suitable for low- and middle-income countries, conducting 160 structured interviews with 12 different stakeholder types across 3 levels of the health system (micro, meso, and macro) in 4 Peruvian regions, each with distinct geographical and urbanization profiles. The second substudy uses a patient journey methodology, which involves conducting 40 in-depth interviews with people with dementia, carers, and health care workers from the same 4 regions. The insights into the people with dementia patient and caregiver experience within the health system from the interviews will be used to produce a patient journey map. The analysis will be guided by the high-quality health system framework, and the findings from the HSA and patient journey will be structured using the domains included in the framework through the lens of quality of services.
Data collection began in March 2024. As of the end of September 2024, a total of 156 interviews from the HSA and 38 interviews from the patient journey study have been conducted across 4 regions.
This study will provide a national, multilevel insight into the current operation of the Peruvian health system, including an analysis of the quality of services provided with regard to dementia diagnosis, management, and care from the perspectives of stakeholders, patients, and their carers.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/60296.
痴呆症是一项全球卫生重点问题，因其性质复杂且患病率不断上升而面临重大挑战。世界各地的卫生系统都在努力应对痴呆症等慢性病，往往提供的是碎片化护理。然而，在低收入和中等收入国家，关于卫生系统如何满足痴呆症患者及其照护者的需求以及所提供护理质量的信息却很匮乏。
本研究旨在评估秘鲁卫生系统为痴呆症患者及其照护者提供诊断和护理的质量。为了做到这一点，该研究将探讨秘鲁卫生系统对痴呆症患者及其照护者的应对情况，并探究痴呆症患者接受诊断、管理及该病症护理质量的经历。
本研究是名为“IMPACT Salud：利用移动健康技术为痴呆症及合并症患者创新”的研究项目的一部分，旨在加强卫生系统为痴呆症患者及其照护者提供护理的能力。该研究采用描述性横断面设计，使用定性方法，包括利益相关者访谈和文件审查，由两个子研究组成，即卫生系统评估（HSA）和患者就医过程探索。第一个子研究采用适用于低收入和中等收入国家的卫生系统评估方法，在秘鲁4个具有不同地理和城市化特征的地区，对卫生系统3个层面（微观、中观和宏观）的12种不同利益相关者类型进行160次结构化访谈。第二个子研究采用患者就医过程方法，对来自相同4个地区的痴呆症患者、照护者和医护人员进行40次深入访谈。访谈中对卫生系统内痴呆症患者和照护者经历的见解将用于绘制患者就医过程图。分析将以高质量卫生系统框架为指导，卫生系统评估和患者就医过程的研究结果将通过服务质量视角，按照框架中包含的领域进行构建。
数据收集于2024年3月开始。截至2024年9月底，已在4个地区进行了156次卫生系统评估访谈和38次患者就医过程研究访谈。
本研究将对秘鲁卫生系统的当前运作提供全国性、多层次的见解，包括从利益相关者、患者及其照护者的角度分析在痴呆症诊断、管理和护理方面所提供服务的质量。
国际注册报告识别号（IRRID）：DERR1-10.2196/60296。
