Harrison L H, Khallaf N, el Mougi M, Koura H, Shobair I, Terreri N
Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD.
Qual Assur Health Care. 1993 Mar;5(1):67-73. doi: 10.1093/intqhc/5.1.67.
To develop an instrument to measure the quality of acute respiratory infection (ARI) case management among Egyptian children.
A baseline survey of all health facilities in a single district, using a multi-data source instrument. Data sources included providers, caretakers, patient records and observation of patient care.
Physicians did not count the respiratory rate and check for subcostal retraction. Eighty-seven per cent of children who did not require antibiotics received them. Of five children who required antibiotics, four (80%) were prescribed an oral regimen. Three of these should have been admitted to a hospital but were not. Antibiotics were available at the facilities an estimated 7.9 months per year. Oxygen for inpatient treatment was available in one of two hospitals.
This instrument was useful for comprehensively evaluating facility capability to provide quality case management. Deficiencies were identified but were not unexpected in a baseline survey. The Egypt ARI program has the potential to have a substantial impact on how children with ARI are diagnosed and treated in health facilities.
开发一种工具来衡量埃及儿童急性呼吸道感染(ARI)病例管理的质量。
使用多数据源工具对单个地区的所有卫生设施进行基线调查。数据来源包括提供者、看护人、患者记录以及对患者护理的观察。
医生未对呼吸频率进行计数,也未检查肋下凹陷情况。87% 不需要使用抗生素的儿童接受了抗生素治疗。在五名需要使用抗生素的儿童中,四名(80%)被开具了口服治疗方案。其中三名儿童本应住院但未住院。这些设施中抗生素每年估计有7.9个月的供应量。两家医院中有一家提供用于住院治疗的氧气。
该工具对于全面评估卫生设施提供高质量病例管理的能力很有用。发现了不足之处,但在基线调查中这并不意外。埃及急性呼吸道感染项目有可能对卫生设施中急性呼吸道感染儿童的诊断和治疗方式产生重大影响。