Evaluation of the quality of adult antiretroviral therapy service in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia, 2023.

Abstract

Introduction: Poor-quality care is now a bigger barrier to reducing mortality than insufficient access. To improve health outcomes, it is important to offer high-quality Human Immune Virus treatment and antiretroviral medication to people living with the disease. Objective: To evaluate the quality of adult antiretroviral therapy service in Dessie Comprehensive Specialized Hospital in Northeast Ethiopia in 2023. Methods: A single case study design with a concurrent mixed method was used from March 28 to April 28, 2023. The evaluation used patient-centeredness, timeliness, compliance and availability dimensions with 31 indicators. A total of 417 client exit-interviews, 6 key informants, 8 in-depth interviews, 418 client chart reviews, 14 observations for patient-provider interaction, and 422 non-participatory observations for waiting time were conducted. Data were entered using EPI-DATA 4.6 and analyzed using STATA 14. Chi square assumption was checked. Binary logistic regression analysis was computed to identify eligible variables to multivariable logistic regression, and in the final model, variables with a p-value<0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to determine statistical significance. Thematic analysis of the qualitative data was performed using OPEN CODE 4.03. Finally, dimensions and overall quality were judged by using predetermined judgment criteria. Results: The overall quality of adult antiretroviral therapy service evaluation in Dessie Comprehensive Specialized Hospital was 74.58 with 72.28% availability, 77.8% compliance, 61.6% timelines, and 79.8% patient-centeredness. Attending higher education (AOR=3.3, 95% CI: 0.25-0 .9), being on ART follow-up for more than 15 years (AOR=0.48, 95%CI: 0.25-0 .9), perceived ART service as easy (AOR=2.7, 95%CI: 1.7-4.6), and being communicated on a plan of care (AOR=1.7, 95% CI: 1.14-2.85) were significantly associated with patient-centeredness. Conclusion and recommendation: The quality of adult antiretroviral therapy service was good, although the availability of resource and timeliness of the service was fair. Educational level, years on antiretroviral therapy, ease of service, and communication on the plan of care were significantly associated with patient–centeredness. Therefore, the quality team should develop strategy to shorten waiting time, health care provider should share plan of care with all client and give emphasis for uneducated clients. Moreover, supplementary food supply should continue.