Quality of Care for Patients with HIV Infection or AIDS : A Case Study in District Hospital, Roi-et Province
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Abstract
This was a retrospective study which aimed to explore quality of care for patients with HIV infection or AIDS in the district hospital in Roi-et Province. Quality of patient care was assessed based on HIVQUAL-T version 4 and 5 including primary prophylaxis for opportunistic infections; antiretroviral therapy adherence; HIV status monitoring (CD4 and/or Viral load); and adverse effects related to antiretroviral therapy, study variables were obtained from several sources including NAP database, HosXP database and medical records. The study sample was patients who had been diagnosed as being infected with HIV or AIDS, according to ICD 10 code B20-B24 during the fiscal year 2008 to 2010 and who met the criteria as follows: 1) age at least 15 years; 2) having outpatient visits at least three times a year; and 3) having CD4 count testing before receiving antiretroviral therapy. The results showed that there were 27.9%, 20.0% and 43.8% of patients in fiscal year 2008, 2009, and 2010 who received antiretroviral drugs within two weeks after having CD4 count testing at baseline. Most patients received drug prophylaxis for Pneumocystis carinii pneumonia (PCP) before starting antiretroviral therapy (100.0%, 93.3% and 95.5%, respectively). In fiscal year 2008 and 2009, most patients had poor adherence and more than half of them (67.4% and 56.7%, respectively) had been monitored for CD4 count testing once a year. In the fiscal year 2010, most patients had good adherence and 50% of them had been monitored for CD4 counts twice a year. An increase trend of proportion of patients who were monitored for HIV-RNA-virus test was observed (46.5%, 90.0% and 90.6%>, respectively). The rate of treatment failure after antiretroviral therapy (virological failure, immunological failure and clinical failure) In each fiscal year was quite low. Adverse effects related to antiretroviral therapy which were found included lipoatrophy, lipohypertrophy and drugs allergic. In conclusion, this hospital provided the clinical care for patients with HIV infection or AIDS according to HIVQUAL-T indicators and continued to improve their quality of care.
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References
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