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

Satisfaction of tuberculosis patients to healthcare services at the global level: A systematic review

Patient satisfaction is a critical component of quality of care assessment in the pursuit of universal health coverage to end the tuberculosis epidemic and other diseases. This study aimed to review the level of satisfaction of tuberculosis patients and related factors. Articles were accessed from Web of Science, EMBASE, PubMed and Google Scholar. Twenty-six papers fulfilled the eligibility criteria from 13 countries. The percentage of satisfied tuberculosis patients ranged from 53.5% to 97.0% in the five African countries, 67.8 to 97.2% in India, South-East Asia, 82.0% in Pakistan, East-Mediterranean and 92.9% in Armenia, the European region. Accessibility, healthcare cost, treatment duration and taking supervised-directly observed treatment were healthcare service-related determinants. Technical competency, interpersonal relationships, confidentiality, time spent with healthcare providers, time spent waiting for care and counselling and health education were health worker-related determinants. Patient-related variables that determine satisfaction were gender, age, ethnicity, place of residence, marital status, educational status, income and health status. Developing and/or approaching an internationally-agreed tool to measure tuberculosis patient satisfaction in healthcare settings will improve the availability of high-quality and comparable data to verify actual variation across and within a country. A multidimensional approach considering clients, health workers and healthcare settings is required to holistically address satisfaction issues of tuberculosis patients to gradually realise universal health coverage.

The feasibility of a public-private mix program on pulmonary tuberculosis screening in Penang: A pilot study

BACKGROUND

The low detection rate of tuberculosis (TB) cases in Malaysia remains a challenge in the effort to end TB by 2030. The collaboration between private and public health care facilities is essential in addressing this issue. As of now, no private-public health care collaborative program in pulmonary tuberculosis (PTB) screening exists in Malaysia.

AIM

To determine the feasibility of a collaborative program between private general practitioners (GPs) and the public primary health clinics in PTB screening and to assess the yield of smear-positive PTB from this program.

METHODS

A prospective cohort study using convenient sampling was conducted involving GPs and public health clinics in the North-East District, Penang, from March 2018 to May 2019. In this study, GPs could direct all suspected PTB patients to perform a sputum acid fast bacilli (AFB) direct smear in any of the dedicated public primary health clinics. The satisfaction level of both the GPs and their patients were assessed using a self-administered client satisfaction questionnaire. IBM SPSS Statistical Software was used to analyze the data.

RESULTS

Out of a total of 31 patients who underwent the sputum investigation for PTB, one (3.2%) was diagnosed to have smear-positive PTB. Most of the patients (>90%) and GPs (66.7%) agreed to continue with this program in the future. Furthermore, most of the patients (>90%) were satisfied with the program structure.

CONCLUSION

It is potentially feasible to involve GPs in combating TB. However, a more structured program addressing the identified issues is needed to make the collaborative program a success.