SETTING: Although health policy in South Africa calls for the integration of services, the effectiveness of different models of integration on patient outcomes has not been well demonstrated. OBJECTIVE: To evaluate the outcomes of coinfected patients starting antiretroviral treatment (ART) in a tuberculosis (TB) hospital who received different models of ongoing care. DESIGN: This cohort study compared outcomes for 271 coinfected patients who started ART in a TB hospital in the Western Cape. After discharge, one group of patients received anti-tuberculosis treatment and ART from different providers, in the same or in different clinics (vertical care). The other group received anti-tuberculosis treatment and ART at the same visit from the same service provider (integrated care). Demographic and clinical data and TB and ART outcomes were compared. RESULTS: The vertical care model had more unfavourable outcomes for anti-tuberculosis treatment (28.7% vs. 5.9%, P < 0.001) and ART (30.1% vs. 7.4%, P < 0.001) than the integrated care model. The vertical care model showed no difference whether services were provided by two service providers in the same or in geographically separate primary health care clinics. CONCLUSION: Patient outcomes were better when TB and HIV care was received from the same service provider at the same visit.
SETTING: Although health policy in South Africa calls for the integration of services, the effectiveness of different models of integration on patient outcomes has not been well demonstrated. OBJECTIVE: To evaluate the outcomes of coinfectedpatients starting antiretroviral treatment (ART) in a tuberculosis (TB) hospital who received different models of ongoing care. DESIGN: This cohort study compared outcomes for 271 coinfectedpatients who started ART in a TB hospital in the Western Cape. After discharge, one group of patients received anti-tuberculosis treatment and ART from different providers, in the same or in different clinics (vertical care). The other group received anti-tuberculosis treatment and ART at the same visit from the same service provider (integrated care). Demographic and clinical data and TB and ART outcomes were compared. RESULTS: The vertical care model had more unfavourable outcomes for anti-tuberculosis treatment (28.7% vs. 5.9%, P < 0.001) and ART (30.1% vs. 7.4%, P < 0.001) than the integrated care model. The vertical care model showed no difference whether services were provided by two service providers in the same or in geographically separate primary health care clinics. CONCLUSION:Patient outcomes were better when TB and HIV care was received from the same service provider at the same visit.
Authors: Sarah M Burnett; Stella Zawedde-Muyanja; Sabine M Hermans; Marcia R Weaver; Robert Colebunders; Yukari C Manabe Journal: J Acquir Immune Defic Syndr Date: 2018-12-15 Impact factor: 3.731
Authors: Matthew D Hickey; Thomas A Odeny; Maya Petersen; Torsten B Neilands; Nancy Padian; Nathan Ford; Zachary Matthay; David Hoos; Meg Doherty; Chris Beryer; Stefan Baral; Elvin H Geng Journal: Implement Sci Date: 2017-08-08 Impact factor: 7.327
Authors: Caroline A Bulstra; Jan A C Hontelez; Moritz Otto; Anna Stepanova; Erik Lamontagne; Anna Yakusik; Wafaa M El-Sadr; Tsitsi Apollo; Miriam Rabkin; Rifat Atun; Till Bärnighausen Journal: PLoS Med Date: 2021-11-09 Impact factor: 11.069
Authors: Michael E Herce; Jill Morse; Dora Luhanga; Jennifer Harris; Helene J Smith; Stable Besa; Graham Samungole; Nzali Kancheya; Monde Muyoyeta; Stewart E Reid Journal: BMC Infect Dis Date: 2018-10-26 Impact factor: 3.090