TY - JOUR
T1 - HIVQUAL-T
T2 - Monitoring and improving HIV clinical care in Thailand, 2002-08
AU - Thanprasertsuk, Sombat
AU - Supawitkul, Somsak
AU - Lolekha, Rangsima
AU - Ningsanond, Peeramon
AU - Agins, Bruce D.
AU - Mcconnell, Michelle S.
AU - Fox, Kimberley K.
AU - Srisongsom, Saowanee
AU - Chunwimaleung, Suchin
AU - Gass, Robert
AU - Simmons, Nicole
AU - Chaovavanich, Achara
AU - Jirajariyavej, Supunnee
AU - Leusaree, Tasana
AU - Akksilp, Somsak
AU - Mock, Philip A.
AU - Chasombat, Sanchai
AU - Lertpiriyasuwat, Cheewanan
AU - Tappero, Jordan W.
AU - Levine, William C.
PY - 2012/8
Y1 - 2012/8
N2 - Objective: We report experience of HIVQUAL-T implementation in Thailand. Design: Program evaluation. Setting: Twelve government hospital clinics. Participants: People living with HIV/AIDS (PLHAs) aged ≥15 years with two or more visits to the hospitals during 2002-08. Intervention: HIVQUAL-T is a process for HIV care performance measurement (PM) and quality improvement (QI). The program includes PM using a sample of eligible cases and establishment of a locally led QI infrastructure and process. PM indicators are based on Thai national HIV care guidelines. QI projects address needs identified through PM; regional workshops facilitate peer learning. Annual benchmarking with repeat measurement is used to monitor progress. Main Outcome Measure: Percentages of eligible cases receiving various HIV services. Results: Across 12 participating hospitals, HIV care caseloads were 4855 in 2002 and 13 887 in 2008. On average, 10-15% of cases were included in the PM sample. Percentages of eligible cases receiving CD4 testing in 2002 and 2008, respectively, were 24 and 99% (P<0.001); for ARV treatment, 100 and 90% (P = 0.74); for Pneumocystis jiroveci pneumonia prophylaxis, 94 and 93% (P = 0.95); for Papanicolau smear, 0 and 67% (P<0.001); for syphilis screening, 0 and 94% (P<0.001); and for tuberculosis screening, 24 and 99% (P<0.01). PM results contributed to local QI projects and national policy changes. Conclusions: Hospitals participating in HIVQUAL-T significantly increased their performance in several fundamental areas of HIV care linked to health outcomes for PLHA. This model of PM-QI has improved clinical care and implementation of HIV guidelines in hospital-based clinics in Thailand.
AB - Objective: We report experience of HIVQUAL-T implementation in Thailand. Design: Program evaluation. Setting: Twelve government hospital clinics. Participants: People living with HIV/AIDS (PLHAs) aged ≥15 years with two or more visits to the hospitals during 2002-08. Intervention: HIVQUAL-T is a process for HIV care performance measurement (PM) and quality improvement (QI). The program includes PM using a sample of eligible cases and establishment of a locally led QI infrastructure and process. PM indicators are based on Thai national HIV care guidelines. QI projects address needs identified through PM; regional workshops facilitate peer learning. Annual benchmarking with repeat measurement is used to monitor progress. Main Outcome Measure: Percentages of eligible cases receiving various HIV services. Results: Across 12 participating hospitals, HIV care caseloads were 4855 in 2002 and 13 887 in 2008. On average, 10-15% of cases were included in the PM sample. Percentages of eligible cases receiving CD4 testing in 2002 and 2008, respectively, were 24 and 99% (P<0.001); for ARV treatment, 100 and 90% (P = 0.74); for Pneumocystis jiroveci pneumonia prophylaxis, 94 and 93% (P = 0.95); for Papanicolau smear, 0 and 67% (P<0.001); for syphilis screening, 0 and 94% (P<0.001); and for tuberculosis screening, 24 and 99% (P<0.01). PM results contributed to local QI projects and national policy changes. Conclusions: Hospitals participating in HIVQUAL-T significantly increased their performance in several fundamental areas of HIV care linked to health outcomes for PLHA. This model of PM-QI has improved clinical care and implementation of HIV guidelines in hospital-based clinics in Thailand.
KW - HIVQUAL
KW - Performance measurement
KW - Quality improvement
KW - Thailand
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UR - http://www.scopus.com/inward/citedby.url?scp=84864520844&partnerID=8YFLogxK
U2 - 10.1093/intqhc/mzs008
DO - 10.1093/intqhc/mzs008
M3 - Article
C2 - 22665387
AN - SCOPUS:84864520844
SN - 1353-4505
VL - 24
SP - 338
EP - 347
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - 4
ER -