Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda

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dc.contributor.authorBakanda, Celestinen_ZA
dc.contributor.authorBirungi, Josephineen_ZA
dc.contributor.authorMwesigwa, Roberten_ZA
dc.contributor.authorZhang, Wendyen_ZA
dc.contributor.authorHagopian, Amyen_ZA
dc.contributor.authorFord, Nathanen_ZA
dc.contributor.authorMills, Edward Jen_ZA
dc.date.accessioned2015-11-23T12:31:11Z
dc.date.available2015-11-23T12:31:11Z
dc.date.issued2011en_ZA
dc.description.abstractObjective 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 significant associations were observed between mortality and physicians ( p  = 0.65), nurses ( p  = 0.49), clinical officers ( p  = 0.73), field officers ( p  = 0.78), and healthcare providers overall ( p  = 0.73). CONCLUSIONS: Patient outcomes, as measured by loss to follow-up and mortality, were not significantly associated with the number of doctors, nurses, clinical officers, field officers, or healthcare providers overall. This may suggest that that other factors, such as the presence of volunteer patient supporters or broader political or socioeconomic influences, may be more closely associated with outcomes of care among patients on cART in Uganda.en_ZA
dc.identifier.apacitationBakanda, C., Birungi, J., Mwesigwa, R., Zhang, W., Hagopian, A., Ford, N., & Mills, E. J. (2011). Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda. <i>PLoS One</i>, http://hdl.handle.net/11427/15308en_ZA
dc.identifier.chicagocitationBakanda, Celestin, Josephine Birungi, Robert Mwesigwa, Wendy Zhang, Amy Hagopian, Nathan Ford, and Edward J Mills "Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda." <i>PLoS One</i> (2011) http://hdl.handle.net/11427/15308en_ZA
dc.identifier.citationBakanda, C., Birungi, J., Mwesigwa, R., Zhang, W., Hagopian, A., Ford, N., & Mills, E. J. (2010). Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda. PloS one, 6(1), e16279. doi:10.1371/journal.pone.0016279en_ZA
dc.identifier.ris TY - Journal Article AU - Bakanda, Celestin AU - Birungi, Josephine AU - Mwesigwa, Robert AU - Zhang, Wendy AU - Hagopian, Amy AU - Ford, Nathan AU - Mills, Edward J AB - 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 significant associations were observed between mortality and physicians ( p  = 0.65), nurses ( p  = 0.49), clinical officers ( p  = 0.73), field officers ( p  = 0.78), and healthcare providers overall ( p  = 0.73). CONCLUSIONS: Patient outcomes, as measured by loss to follow-up and mortality, were not significantly associated with the number of doctors, nurses, clinical officers, field officers, or healthcare providers overall. This may suggest that that other factors, such as the presence of volunteer patient supporters or broader political or socioeconomic influences, may be more closely associated with outcomes of care among patients on cART in Uganda. DA - 2011 DB - OpenUCT DO - 10.1371/journal.pone.0016279 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda TI - Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda UR - http://hdl.handle.net/11427/15308 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15308
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0016279
dc.identifier.vancouvercitationBakanda C, Birungi J, Mwesigwa R, Zhang W, Hagopian A, Ford N, et al. Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda. PLoS One. 2011; http://hdl.handle.net/11427/15308.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2011 Bakanda et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHealth care providersen_ZA
dc.subject.otherAllied health care professionalsen_ZA
dc.subject.otherDeath ratesen_ZA
dc.subject.otherUgandaen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherNursesen_ZA
dc.subject.otherPhysiciansen_ZA
dc.subject.otherAIDSen_ZA
dc.titleDensity of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Ugandaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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