HIV/AIDS health services in Manaus, Brazil: patient perception of quality and its influence on adherence to antiretroviral treatment.
ART adherence
Brazil
Decentralized healthcare
HIV services
Patient satisfaction
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
30 May 2019
30 May 2019
Historique:
received:
18
06
2018
accepted:
05
04
2019
entrez:
1
6
2019
pubmed:
31
5
2019
medline:
20
8
2019
Statut:
epublish
Résumé
Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients' perception of the quality of health services on adherence to antiretroviral treatment using the decentralized care model in Manaus, Brazil. We conducted a non-randomized, cross-sectional analysis to explore the relationship between patient satisfaction and adherence to antiretroviral treatment (ART) in Manaus, Amazonas, Brazil. We also compared patient satisfaction levels at the city's main hospital with those at smaller health units established to decentralize HIV/AIDS healthcare. Using survey responses from 812 patients and health data from 713 patients, we conducted descriptive and regression analyses to identify health center characteristics associated with higher patient satisfaction and higher adherence to treatment. We found a clear and positive relationship between patient satisfaction with the quality of health services and adherence to ART. Patients who had better access to their health center and its services -mainly in the form of convenient location, shorter commute times, and shorter wait times- tended to rate the quality of services higher and were also more likely to adhere to ART. We also found higher levels of patient satisfaction and adherence to ART among patients served at decentralized health units than among patients served at the main hospital. The study's results emphasize the importance of patients' experience at the health center for improved health outcomes. While many of the factors that play a role in whether a patient adheres to ART or not are beyond the control of the health center, our findings highlight that health centers can importantly contribute to increased ART adherence by improving such experience. The study also showcases the potential benefits of decentralizing HIV care to increase patient satisfaction and, with it, adherence to ART.
Sections du résumé
BACKGROUND
BACKGROUND
Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients' perception of the quality of health services on adherence to antiretroviral treatment using the decentralized care model in Manaus, Brazil.
METHODS
METHODS
We conducted a non-randomized, cross-sectional analysis to explore the relationship between patient satisfaction and adherence to antiretroviral treatment (ART) in Manaus, Amazonas, Brazil. We also compared patient satisfaction levels at the city's main hospital with those at smaller health units established to decentralize HIV/AIDS healthcare. Using survey responses from 812 patients and health data from 713 patients, we conducted descriptive and regression analyses to identify health center characteristics associated with higher patient satisfaction and higher adherence to treatment.
RESULTS
RESULTS
We found a clear and positive relationship between patient satisfaction with the quality of health services and adherence to ART. Patients who had better access to their health center and its services -mainly in the form of convenient location, shorter commute times, and shorter wait times- tended to rate the quality of services higher and were also more likely to adhere to ART. We also found higher levels of patient satisfaction and adherence to ART among patients served at decentralized health units than among patients served at the main hospital.
CONCLUSIONS
CONCLUSIONS
The study's results emphasize the importance of patients' experience at the health center for improved health outcomes. While many of the factors that play a role in whether a patient adheres to ART or not are beyond the control of the health center, our findings highlight that health centers can importantly contribute to increased ART adherence by improving such experience. The study also showcases the potential benefits of decentralizing HIV care to increase patient satisfaction and, with it, adherence to ART.
Identifiants
pubmed: 31146738
doi: 10.1186/s12913-019-4062-9
pii: 10.1186/s12913-019-4062-9
pmc: PMC6543648
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Pagination
344Références
Ann Intern Med. 2000 Jul 4;133(1):21-30
pubmed: 10877736
AIDS Patient Care STDS. 2002 Jan;16(1):43-50
pubmed: 11839218
J Fam Pract. 2004 Sep;53(9):721-30
pubmed: 15353162
AIDS Care. 2005 May;17(4):493-504
pubmed: 16036235
Health Psychol. 2007 Jan;26(1):40-9
pubmed: 17209696
Psychother Psychosom. 2008;77(4):219-26
pubmed: 18418028
BMC Health Serv Res. 2008 Aug 07;8:167
pubmed: 18687113
BMC Health Serv Res. 2008 Oct 09;8:210
pubmed: 18844998
AIDS Patient Care STDS. 2009 May;23(5):365-9
pubmed: 19323606
East Afr J Public Health. 2008 Dec;5(3):174-9
pubmed: 19374320
Bull World Health Organ. 2009 Apr;87(4):271-8
pubmed: 19551235
Int J Qual Health Care. 2009 Oct;21(5):356-62
pubmed: 19684032
BMC Health Serv Res. 2010 Mar 24;10:78
pubmed: 20334649
BMC Infect Dis. 2011 Apr 06;11:86
pubmed: 21466704
Health Policy Plan. 2012 Jul;27(4):301-15
pubmed: 21690123
Lancet Infect Dis. 2011 Dec;11(12):942-51
pubmed: 22030332
J Gen Intern Med. 2012 Sep;27(9):1159-64
pubmed: 22528619
J Acquir Immune Defic Syndr. 2012 Aug 15;60(5):466-72
pubmed: 22595873
PLoS One. 2012;7(10):e46680
pubmed: 23071611
PLoS One. 2013;8(1):e54729
pubmed: 23382948
AIDS Res Treat. 2013;2013:485715
pubmed: 23738055
Clinics (Sao Paulo). 2013 May;68(5):612-20
pubmed: 23778401
AIDS Behav. 2014 Aug;18(8):1541-7
pubmed: 24213215
BMC Health Serv Res. 2014 Jan 23;14:32
pubmed: 24450409
Am J Public Health. 2015 Apr;105(4):725-31
pubmed: 24922167
Med Care Res Rev. 2014 Oct;71(5):522-54
pubmed: 25027409
Health Policy Plan. 2014 Sep;29 Suppl 2:ii50-8
pubmed: 25274640
AIDS Care. 2016 Nov;28(11):1441-7
pubmed: 27144342
J Behav Med. 2016 Dec;39(6):1056-1064
pubmed: 27392477
LGBT Health. 2017 Jun;4(3):227-231
pubmed: 28358625
Sci Rep. 2018 Feb 16;8(1):3133
pubmed: 29453393
J AIDS Clin Res. 2018;9(2):null
pubmed: 29682399
Med Care. 1993 Feb;31(2):182-8
pubmed: 8433580