Knoblauch Astrid M, Rajkumar Sarah, Canavan Robert, Ramadani Qamile, Katanolli Ariana Bytyçi, Bahtiri Shegë, Stevenson Debra, Mustafa Merita Stavileci, Fota Nicu, Gerold Jana
Swiss Tropical and Public Health Institute, Swiss Center for International Health, Allschwil, Switzerland.
University of Basel, Basel, Switzerland.
Front Public Health. 2025 Jul 2;13:1596249. doi: 10.3389/fpubh.2025.1596249. eCollection 2025.
Access to quality primary healthcare (PHC) in Kosovo is progressive with substantial reforms that have been implemented to promote the health of its people since its independence in 2008. However, substantial challenges remain, particularly among managing non-communicable diseases (NCD) like diabetes and hypertension, due to gaps in structural and procedural aspects. The Accessible Quality Healthcare project (2016-2027) aimed at improving the health of the Kosovar population by strengthening the quality of PHC services with a specific focus on NCDs. Three quality of care studies were conducted with the aim of measuring progress in PHC and NCD management.
Three facility-based, cross-sectional studies were conducted in 2016, 2018 and 2023 across 12, 20, and 38 selected municipalities in Kosovo, respectively. Data were collected on PHC infrastructure, provider-patient interactions, and patient outcomes using standardized assessments, observational tools, and exit interviews.
The overall infrastructure score improved from 56% in 2016 to 68% in 2023. Clinical observation scores comprised five categories. For instance, doctors' knowledge and compliance with clinical history and physical examinations revealed a marked increase overall from 2016 to 2023, hygiene and infection prevention control measures increased steadily in 14 municipalities but remained below 60% in 16 municipalities. Clinical adherence to guidelines for managing diabetes and hypertension improved markedly but remained low overall (from 36% in 2016 to 60% in 2023 with regards to diabetes and 35% in 2016 to 58% in 2023 regarding hypertension). The overall experience of patients exiting facilities was positive and their perception of doctors' behaviour scored more than 60% in all years and in seven of the eight indicators. Negative exceptions included a drop in explanations regarding medicine intake from 96% in 2016 to 56% in 2023 and regarding the doctors' verbal anamnesis, physical examination and explaining the health problems (from 97% in 2016 to 77% in 2023).
While marked progress was made in improving Kosovo's healthcare infrastructure and clinical practices, persistent disparities in municipal performance and gaps in doctor-patient communication highlight the need for targeted interventions. Continued investment in healthcare worker training, better adherence to clinical protocols, and improved communication will be essential to sustain progress and align Kosovo's healthcare system with European Union standards.
自2008年独立以来，科索沃一直在进行重大改革，以逐步实现民众获得优质初级医疗保健（PHC）的目标，从而促进民众健康。然而，仍然存在重大挑战，尤其是在管理糖尿病和高血压等非传染性疾病（NCD）方面，因为在结构和程序方面存在差距。可及优质医疗保健项目（2016 - 2027年）旨在通过加强初级医疗保健服务质量，特别是关注非传染性疾病，来改善科索沃民众的健康状况。为此开展了三项医疗质量研究，以衡量初级医疗保健和非传染性疾病管理方面的进展。
2016年、2018年和2023年分别在科索沃选定的12个、20个和38个城市进行了三项基于机构的横断面研究。使用标准化评估、观察工具和出院访谈收集了有关初级医疗保健基础设施、医护人员与患者互动以及患者治疗结果的数据。
总体基础设施得分从2016年的56%提高到2023年的68%。临床观察得分包括五个类别。例如，医生在临床病史和体格检查方面的知识和依从性从2016年到2023年总体有显著提高，14个城市的卫生和感染预防控制措施稳步增加，但16个城市仍低于60%。在糖尿病和高血压管理指南的临床依从性方面有显著改善，但总体仍较低（糖尿病方面从2016年的36%提高到2023年的60%；高血压方面从2016年的35%提高到2023年的58%）。患者出院时的总体体验是积极的，他们对医生行为的评价在所有年份以及八项指标中的七项中得分均超过60%。负面例外情况包括关于药物服用解释从2016年的96%降至2023年的56%，以及医生的口头问诊、体格检查和健康问题解释（从2016年的97%降至2023年的77%）。
虽然在改善科索沃的医疗基础设施和临床实践方面取得了显著进展，但各城市表现的持续差异以及医患沟通方面的差距凸显了有针对性干预措施的必要性。持续投资于医护人员培训、更好地遵守临床方案以及改善沟通对于维持进展并使科索沃的医疗系统符合欧盟标准至关重要。
