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Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission

In this article, we describe the framework of the Lancet Global Health Commission on High Quality Health Systems, propose new and undermeasured indicators of TB care quality, and discuss implications of the Commission's key conclusions for measuring and improving the quality of TB care services...

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Detalles Bibliográficos
Autores principales: Arsenault, Catherine, Roder-DeWan, Sanam, Kruk, Margaret E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716550/
https://www.ncbi.nlm.nih.gov/pubmed/31497655
http://dx.doi.org/10.1016/j.jctube.2019.100112
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author Arsenault, Catherine
Roder-DeWan, Sanam
Kruk, Margaret E.
author_facet Arsenault, Catherine
Roder-DeWan, Sanam
Kruk, Margaret E.
author_sort Arsenault, Catherine
collection PubMed
description In this article, we describe the framework of the Lancet Global Health Commission on High Quality Health Systems, propose new and undermeasured indicators of TB care quality, and discuss implications of the Commission's key conclusions for measuring and improving the quality of TB care services. The Commission contends that measurement of quality should focus on the processes of care and their impacts. In addition to monitoring treatment coverage and the availability of tools, governments should consider indicators of clinical competence (for e.g. ability of providers to correctly diagnose TB and adhere to treatment guidelines), of timely, continuous and integrated care and of respectful and patient-centered care. Indicators of impact include TB mortality and treatment success rates, but also quality of life and daily functioning among TB patients, public trust in TB services, and bypassing of the formal health system for TB care. Cascades of care, from initial care seeking to recurrence-free survival, should be built in every high-burden country to monitor quality longitudinally. In turn, improvement efforts should target the foundations of health systems and consider the Commission's four universal actions: governing for quality, redesigning service delivery, transforming the health workforce and igniting demand for quality TB services. Important work remains to validate new indicators of TB care quality, develop data collection systems for new measures, and to test new strategies for improving the delivery of competent and respectful TB care.
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spelling pubmed-67165502019-09-05 Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission Arsenault, Catherine Roder-DeWan, Sanam Kruk, Margaret E. J Clin Tuberc Other Mycobact Dis Article In this article, we describe the framework of the Lancet Global Health Commission on High Quality Health Systems, propose new and undermeasured indicators of TB care quality, and discuss implications of the Commission's key conclusions for measuring and improving the quality of TB care services. The Commission contends that measurement of quality should focus on the processes of care and their impacts. In addition to monitoring treatment coverage and the availability of tools, governments should consider indicators of clinical competence (for e.g. ability of providers to correctly diagnose TB and adhere to treatment guidelines), of timely, continuous and integrated care and of respectful and patient-centered care. Indicators of impact include TB mortality and treatment success rates, but also quality of life and daily functioning among TB patients, public trust in TB services, and bypassing of the formal health system for TB care. Cascades of care, from initial care seeking to recurrence-free survival, should be built in every high-burden country to monitor quality longitudinally. In turn, improvement efforts should target the foundations of health systems and consider the Commission's four universal actions: governing for quality, redesigning service delivery, transforming the health workforce and igniting demand for quality TB services. Important work remains to validate new indicators of TB care quality, develop data collection systems for new measures, and to test new strategies for improving the delivery of competent and respectful TB care. Elsevier 2019-06-19 /pmc/articles/PMC6716550/ /pubmed/31497655 http://dx.doi.org/10.1016/j.jctube.2019.100112 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arsenault, Catherine
Roder-DeWan, Sanam
Kruk, Margaret E.
Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission
title Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission
title_full Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission
title_fullStr Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission
title_full_unstemmed Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission
title_short Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission
title_sort measuring and improving the quality of tuberculosis care: a framework and implications from the lancet global health commission
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716550/
https://www.ncbi.nlm.nih.gov/pubmed/31497655
http://dx.doi.org/10.1016/j.jctube.2019.100112
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