Whole-course quality of tuberculosis (TB) care in rural China: a retrospective study based on chart abstraction.
BMJ Open
; 14(5): e080844, 2024 May 31.
Article
en En
| MEDLINE
| ID: mdl-38821576
ABSTRACT
OBJECTIVES:
The aim of this study was to assess the quality of tuberculosis (TB) care for the whole course and assess factors that affect completing treatment.DESIGN:
This is an observational retrospective study using chart abstraction for the whole course of TB care conducted at two underserved provinces in China.SETTING:
The study was conducted from June 2021 to July 2021. All medical records (outpatient and inpatient) for the whole course (6-8 months) of patients with TB newly registered from July 2020 to December 2020 were reviewed and abstracted using predetermined checklists.PARTICIPANTS:
A total of 268 outpatient medical records and 126 inpatient records were included. PRIMARY AND SECONDARY OUTCOMEMEASURES:
The primary outcome included diagnostic quality, treatment quality and management quality. The secondary outcome was completing treatment.RESULTS:
For diagnostic quality, 94.2% of the diagnosis were based on adequate evidence. For treatment quality, 240 (91.6%) outpatients and 100 (85.5%) inpatients took the standard chemotherapy regimens. 234 (87.3%) patients completed treatment. 85.1% of the inpatients prescribed with second-line drugs were inappropriate. For management quality, 128 (47.9%) patients received midterm assessments, but only 47 (19.7%) received sufficient services for the whole course. Patients with TB symptoms were 1.8 times more likely to complete treatment (p=0.011).CONCLUSION:
Patients with TB received high-quality diagnosis and treatment services, but low-quality whole-course management. Integration of medical and public health services should be strengthened to improve whole-course quality.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Calidad de la Atención de Salud
/
Tuberculosis
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
BMJ Open
Año:
2024
Tipo del documento:
Article
País de afiliación:
China