Abstract
OBJECTIVE To evaluate factors associated with users’ satisfaction in the Tuberculosis Control Program.METHODS A cross-sectional study of 295 patients aged ≥ 18 years, with two or more outpatient visits in the Tuberculosis Control Program, in five cities in the metropolitan region of Rio de Janeiro, RJ, Southeastern Brazil, in 2010. Considering an estimated population of 4,345 patients, the sampling plan included 15 health care units participating in the program, divided into two strata: units in Rio de Janeiro City, selected with probability proportional to the monthly average number of outpatient visits, and units in the other four cities. In the units, four temporal clusters of five patients each were selected with equal probability, totaling 300 patients. A questionnaire investigating the users’ clinical and sociodemographic variables and aspects of care and service in the program relevant to user satisfaction was applied to the patients. Descriptive statistics about users and their satisfaction with the program were obtained, and the effects of factors associated with satisfaction were estimated.RESULTS Patients were predominantly males (57.7%), with a mean age of 40.9 and with low level of schooling. The mean treatment time was 4.1 months, mostly self-administered (70.4%). Additionally, 25.8% had previously been treated for tuberculosis. There was a high level of satisfaction, especially regarding medication provision, and respect to patients by the health professionals. Patients who were younger (≤ 30), those on self-administered treatment, and with graduate level, showed less satisfaction. Suggestions to improve the services include having more doctors (70.0%), and offering exams in the same place of attendance (55.1%).CONCLUSIONS Patient satisfaction with the Tuberculosis Control Program was generally high, although lower among younger patients, those with university education and those on self-administered treatment. The study indicates the need for changes to structural and organizational aspects of care, and provides practical support for its improvement.
Highlights
Highly effective treatment has been available for decades and there were significant reductions in disease load between 1990 and 2010, tuberculosis (TB) remains a serious public health problem
Efforts have been made and goals set for reducing the disease, a highlight being the Stop TB Strategy, consisting of six components: expanding and strengthening the directedobserved treatment strategy – DOTS); facing up to the challenges of multi-resistant tuberculosis and the TB-HIV co-infection epidemic; strengthening health care systems; commitment on the part of health care providers to controlling tuberculosis and caring for patients; increasing the empowerment of those with TB, and of the community, through partnerships; and investing in research and development of new forms of diagnosis, medicines and vaccines.[17]
A cross-sectional study was conducted on the survey population comprising patients aged ≥ 18, with at least two consultations in the Tuberculosis Control Program (TCP), and treated in the municipalities of Duque de Caxias, Nova Iguaçu, Rio de Janeiro, Sao Joao de Meriti, and Sao Gonçalo, all with high prevalence of the disease and together accounting for 86.0% of new cases of tuberculosis in the metropolitan region of Rio de Janeiro, RJ, in 2009
Summary
Highly effective treatment has been available for decades and there were significant reductions in disease load between 1990 and 2010, tuberculosis (TB) remains a serious public health problem. Brazil currently occupies 19th place on the list of the 22 countries responsible for 81.0% of tuberculosis cases in the world[17] and has placed the disease on its strategic agenda, with decreases recorded in incidence (from 42.8 to 36.0/100 thousand inhabitants) and mortality Between 2008 and 2010, an increase was observed in multi-drug resistant tuberculosis (MDR-TB), from 365 to 605 reported cases This situation poses a challenge in coping with the disease, as such cases often involve individuals with a history of abandoning treatment, requiring treatment for longer periods of time, using stronger drugs that have more side effects and are associated with less favorable results.a
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