Satisfaction Level of Tuberculosis Patients Regarding Their Access to TB Care and Prevention Services, Delivered Through a Public-Private Mix Model in Pakistan.

Ali Ali,Tahir Tahir,Naureen Naureen,Anjum Anjum,Rashid Rashid,Usman Usman,Ishaq Ishaq

doi:10.3390/healthcare7040119

Abstract

Objective: The private healthcare providers (PHCP) are believed to improve access to healthcare services in public–private mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to determine the satisfaction level of tuberculosis (TB) patients. Design: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from a sample frame of 75 districts. In each selected district, the data collector retrieved a TB register of 8 months (January–August 2017) and systematically selected patients by fixed periodic interval. SPSS version 24.0 (IBM Corp, Amonk, NY, USA) was used to analyze the data. Results: This study included 53% (n = 301) males and 47% (n = 271) females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n = 289), and 64% (n = 365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n = 407), including private hospitals/clinics (44%) and traditional practitioners (27%; n = 153); 55% of participants visited their current doctor because of the clinic’s proximity to their residence. Of the participants, 82% (n = 469) were satisfied with TB care services and 85% (n = 488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage and better health outcomes of the population.

Highlights

In response to The End TB Strategy, countries should place patients at the center of the care delivery system by adopting innovative and cost-effective approaches
Evidence suggests that public–private mix (PPM) interventions have achieved increased case notification, treatment outcomes, and patient satisfaction [3,4]
The link between treatment adherence and patient satisfaction level is already established, and it is demonstrated that dissatisfied patients may become non-compliant to treatment protocols or miss their consultation appointments [5,6]

Summary

Introduction

In response to The End TB (tuberculosis) Strategy, countries should place patients at the center of the care delivery system by adopting innovative and cost-effective approaches. It is essential to advance the fight against TB by promoting access and utilization of healthcare services, so that the goal of ending TB by 2030 is achieved [1]. The perception of the patient about his/her own health status is a determining factor for the patient’s treatment adherence and treatment outcome [2]. Evidence suggests that public–private mix (PPM) interventions have achieved increased case notification, treatment outcomes, and patient satisfaction [3,4]. The link between treatment adherence and patient satisfaction level is already established, and it is demonstrated that dissatisfied patients may become non-compliant to treatment protocols or miss their consultation appointments [5,6]. On the contrary, satisfied patients are less likely to encounter challenges in gaining access to healthcare services [7]. Focus of medical attention is shifted from illness-centered care to patient-centered care [8]

Results

Discussion

Conclusion