density of healthcare providers and patient outcomes evidence from a nationally representative multi-site hiv treatment program in uganda密度的卫生保健提供者和病人结果证据从一个全国代表性的多站点在乌干达艾滋病治疗项目.pdfVIP

Density of Healthcare Providers and Patient Outcomes: Evidence from a Nationally Representative Multi-Site HIV Treatment Program in Uganda 1 1 1 2 3 Celestin Bakanda , Josephine Birungi , Robert Mwesigwa , Wendy Zhang , Amy Hagopian , Nathan 4 5 Ford , Edward J. Mills * 1The AIDS Support Organization, Headquarters, Kampala, Uganda, 2 British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, 3 Division of Infectious Diseases, University of Cape Town, Cape Town, South Africa, 4 Health Alliance International, School of Public Health, University of Washington, Seattle, Washington, United States of America, 5 Faculty of Health Sciences, University of Ottawa, Ottawa, Canada Abstract Objective: We examined the association between density of healthcare providers and patient outcomes using a large nationally representative cohort of patients receiving combination antiretroviral therapy (cART) in Uganda. Design: We obtained data from The AIDS Support Organization (TASO) in Uganda. Patients 18 years of age and older who initiated cART at TASO between 2004 and 2008 contributed to this analysis. The number of healthcare providers per 100 patients, the number of patients lost to follow-up per 100 person years and number of deaths per 100 person years were calculated. Spearman correlation was used to identify associations between patient loss to follow-up and mortality with the healthcare provider-patient ratios. Results: We found no significant associations between the number of patients lost to follow-up and physicians (p = 0.45), nurses (p = 0.93), clinical officers (p = 0.80), field officers (p = 0.56), and healthcare providers overall (p = 0.83). Similarly, no signif