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Grigoryan Z, Truzyan N, Petrosyan V. Patient-centered approaches applied in inpatient and outpatient TB services in Armenia. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Healthcare system performance indicators are common instruments measuring and facilitating quality improvement. The End-TB strategy urges provision of integrated patient-centered (PC) care for all forms of tuberculosis (TB). This study aimed to assess and compare quality of inpatient and outpatient TB services using international standards on specific PC indicators to identify potential targets for improvement.
Methods
Joint Commission International (JCI) accreditation standards, adapted to local needs and context, were used as a basic instrument for qualitative and quantitative data collection. We utilized Patient and Family Right (PFR) and Patient and Family Education (PFE) 15 standards with 49 measurable elements as PC indicators for the nationwide assessment of TB services. A scoring system and a scaling approach were used to convert all-source-data and present the overall performance of services.
Results
We reviewed and analyzed data from 10 legal documents, 34 medical records and 155 interviews and focus group discussions with TB healthcare providers, patients and family members from inpatient and outpatient TB services to define the degree of compliance of their practices and treatment experiences to JCI standards. Outpatient TB services met the PFR and PFE standards at the 51%-level receiving a grading of partially performed and requiring improvements. The inpatient services met the PFR and PFE standards at 39%- and 26%-level respectively, receiving a grading of minimally performed for the JCI standards, showing statistically significantly less patient centeredness compared to the outpatient services (p = 0.007, CI 0.234; 0.4234), and requiring major improvements.
Conclusions
Strengthening interventions towards patient-centeredness are essential in both inpatient and outpatient services, but Armenia needs to put more emphasis on inpatient care to bridge the gap between the existing and recommended practices.
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Affiliation(s)
- Z Grigoryan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - N Truzyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - V Petrosyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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Truzyan N. Population mobility and Tuberculosis-HIV/AIDS co-morbidity rates in Armenia. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Truzyan
- American University of Armenia, Yerevan, Armenia
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Musheghyan L, Truzyan N, Petrosyan V. Patients and family rights in an inpatient tuberculosis facility in Armenia. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Musheghyan
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - N Truzyan
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - V Petrosyan
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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Truzyan N, Petrosyan V, Harutyunyan A, Khachadourian V, Thompson M. Depressive symptoms among TB patients in Armenia, 2015. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Harutyunyan A, Truzyan N, Petrosyan V. Factors associated with smoking status among tuberculosis patients in Armenia. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Truzyan N. Barriers for better emergency medical services in Armenia trigger distrust of the general population towards services. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Grigoryan R, Petrosyan V, Martirosyan H, Truzyan N, Crape B, Melkomian DM, Koshkakaryan M. Risk factors for developing drug-resistant tuberculosis from regular tuberculosis in Armenia: a case-control study, 2012. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chekijian S, Cone D, Virabyan A, Khamouchyan N, Truzyan N. Cardiopulmonary Resuscitation in the Republic of Armenia. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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