Improving access to quality of care for drug-resistant tuberculosis patients: a qualitative study on patient-centered support system
10.3760/cma.j.cn111325-20211104-01013
- VernacularTitle:耐药结核病患者支持体系提高诊疗服务可及性的定性研究
- Author:
Yuge ZHANG
1
;
Jingting LU
;
Limei ZHU
;
Song YAO
;
Bin CHEN
;
Xubin ZHENG
;
Beibei CHE
;
Zhipeng LI
;
Qi ZHAO
;
Biao XU
Author Information
1. 复旦大学公共卫生学院流行病学教研室 国家卫生健康委员会卫生技术评估重点实验室，上海 200032
- Keywords:
Health services administration;
Patient-centered support system;
Multidrug-resistant/rifampicin-resistant;
Tuberculosis;
Stakeholders;
Qualitative study
- From:
Chinese Journal of Hospital Administration
2022;38(4):274-279
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the role of patient support system in multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment adherence and outcome, and provide evidence for deepening the patient-centered support system.Methods:Based on the stakeholder analysis, definite stakeholders (administrators from the Department of Medical Insurance, and those from the provincial CDC), expectant stakeholders (administrators from regional CDC, health workers from primary CDCs, medical workers from designated MDR/RR-TB hospitals and MDR/RR-TB patients), and latent stakeholders (MDR/RR-TB patient families and their neighbors or colleagues) were selected using a purposive sampling. These stakeholders were subject to a semi-structured interview on patient support. The inclusion of participants ceased after reaching code or thematic saturation and meaning saturation, while thematic framework analysis was applied in interview data.Results:The 25 interviewees included could be categorized into three groups of stakeholders, i. e., 4 definite stakeholders, 19 expectant stakeholders and 2 latent stakeholders. Three themes summarized in this regard were definite stakeholders providing policy support to advance these patients′ access to standardized diagnosis and treatment services; diagnosis and treatment and management support of expectant stakeholders of these patients to encourage their compliance to treatment and enable their access to high quality medical care; and support from latent stakeholders as a critical guarantee for the patients to welcome a desirable treatment outcome. Psychological support provided under MDR/RR-TB basic care program in some provinces contributed positively to raising patients′ compliance. Economic support, treatment support from family menmbers ccould help the patients to welcome desirable outcomes.Conclusions:MDR/RR-TB patient-centered support system operating in the Yangtze River delta provide the patients with MDR/RR-TB diagnostic and treatment services of some accessibility. Given the progress, there are still shortcomings for the respective stakeholders to enhance their attention and collaboration to improve the access and equity to medical service.
