Progress towards unique patient identification and case-based surveillance within the Southern African development community.

Progress towards unique patient identification and case-based surveillance within the Southern African development community.
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DOI:
10.1177/14604582221139058
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发表时间:
2023-01
影响因子:
3
通讯作者:
Miot, Jacqui
Miot, Jacqui
中科院分区:
医学3区
文献类型:
--
作者:
Govender, Kerensa;Long, Lawrence;Miot, Jacqui

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人口流动性使得南非发展共同体 (SADC) 的患者追踪和护理联系面临挑战。建议通过与唯一患者标识符 (UPI) 关联的个体级临床数据进行基于病例的监测 (CBS)。我们对选定的 SADC 国家内 UPI 和 CBS 的实施情况进行了混合方法分析,其中包括: (1) SADC UPI 实施文献综述; (2) 评估艾滋病毒高流行南部非洲发展共同体国家的 UPI 和 CBS 实施情况; (3) 在选定的南非初级医疗保健 (PHC) 机构中实施 UPI 的案例研究。缺乏对南部非洲发展共同体地区 CBS 和 UPI 实施的研究。现有的患者识别方法经常失败并限制患者追踪。纸质记录和健康信息系统之间的不良集成进一步限制了患者追踪。大多数国家都处于 CBS 的早期和中期阶段,面临着 UPI 的挑战。我们对南非的案例研究发现,UPI 经常未被捕获。在提供功能可靠的 UPI 之前,在预防和护理级联中追踪患者的困难将持续存在。
Population mobility makes patient-tracking and care linkage in the South African Development Community (SADC) challenging. Case-based surveillance (CBS) through individual-level clinical data linked with a unique patient-identifier (UPI) is recommended. We conducted a mixed-methods landscape analysis of UPI and CBS implementation within selected SADC countries, this included: (1) SADC UPI implementation literature review; (2) assessment of UPI and CBS implementation for high HIV-prevalence SADC countries; (3) UPI implementation case-study in selected South African primary healthcare (PHC) facilities. Research into CBS and UPI implementation for the SADC region is lacking. Existing patient-identification methods often fail and limit patient-tracking. Paper-based records and poor integration between health-information systems further restrict patient-tracking. Most countries were in the early-middle stages of CBS and faced UPI challenges. Our South African case-study found that the UPI often goes uncaptured. Difficulties tracking patients across prevention and care cascades will continue until a functional and reliable UPI is available.
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