扩大ART实施：组织文化与早期死亡率数据集

数据集获取（Figshare）

• 源站标题：Scaling up implementation of ART: Organizational culture and early mortality of patients initiated on ART in Nairobi, Kenya
• DOI：10.1371/journal.pone.0190344
• 发布日期：2018-01-02
• 文件数：8 个
• 文件总体积：882.33 KB
• 源站页面：https://plos.figshare.com/articles/dataset/Scaling_up_implementation_of_ART_Organizational_culture_and_early_mortality_of_patients_initiated_on_ART_in_Nairobi_Kenya/5750040

命令行下载

curl -L -o "S1 Appendix.docx" "https://ndownloader.figshare.com/files/10133598"
curl -L -o "S2 Appendix.docx" "https://ndownloader.figshare.com/files/10133622"
curl -L -o "S3 Appendix.docx" "https://ndownloader.figshare.com/files/10133631"
curl -L -o "S4 Appendix.sav" "https://ndownloader.figshare.com/files/10133640"
curl -L -o "S5 Appendix.sav" "https://ndownloader.figshare.com/files/10133652"
curl -L -o "S6 Appendix.xls" "https://ndownloader.figshare.com/files/10133661"
curl -L -o "S7 Appendix.pdf" "https://ndownloader.figshare.com/files/10133673"
curl -L -o "S8 Appendix.xlsx" "https://ndownloader.figshare.com/files/10133676"

文件清单

• S1 Appendix.docx（91.21 KB）
• S2 Appendix.docx（22.29 KB）
• S3 Appendix.docx（106.12 KB）
• S4 Appendix.sav（32.15 KB）
• S5 Appendix.sav（4.82 KB）
• S6 Appendix.xls（483.33 KB）
• S7 Appendix.pdf（122.04 KB）
• S8 Appendix.xlsx（20.37 KB）

文件总体积 882.33 KB（源站 API 实测）。

数据说明

Background
Scaling up the antiretroviral (ART) program in Kenya has involved a strategy of using clinical guidelines coupled with decentralization of treatment sites. However decentralization pushes clinical responsibility downwards to health facilities run by lower cadre staff. Whether the organizational culture in health facilities affects the outcomes despite the use of clinical guidelines has not been explored. This study aimed to demonstrate the relationship between organizational culture and early mortality and those lost to follow up (LTFU) among patients enrolled for HIV care.
Methods and materials
A stratified sample of 31 health facilities in Nairobi County offering ART services were surveyed. Data of patients enrolled on ART and LTFU for the 12 months ending 30th June 2013 were abstracted. Mortality and LTFU were determined and used to rank health facilities. In the facilities with the lowest and highest mortality and LTFU key informant interviews were conducted using a tool adapted from team climate assessment measurement questionnaire and competing value framework tool to assess organizational culture. The strength of association between early mortality, LTFU and organizational culture was tested.
Results
Half (51.8%) of the 5,808 patients enrolled into care in 31 health facilities over the 12-month study period were started on ART. Of these 48 (1.6% 95% CI 0.8%-2.4%) died within three months of starting treatment, while a further 125 (4.2% 95% CI 2.1%-6.6%) were LTFU giving an attrition rate of 5.7% (95% CI 3.3%-8.6%). Tuberculosis was the most common comorbidity associated with high early mortality and high LTFU. Organizational culture, specifically an adhocratic type was found to be associated with low early mortality and low LTFU of patients enrolled for HIV care (P = 0.034).
Conclusion
The use of ART clinical guidelines in a decentralized health systems are not sufficient to achieve required service delivery outcomes. The attrition rate above would mean 85,000 Kenyans missing care based on current HIV disease burden figures. Deliberate efforts to improve individual health facility leadership and inculcate an adhocratic culture may lower mortali

许可

CC BY 4.0

引用

学术使用请引用 DOI 10.1371/journal.pone.0190344（source: https://plos.figshare.com/articles/dataset/Scaling_up_implementation_of_ART_Organizational_culture_and_early_mortality_of_patients_initiated_on_ART_in_Nairobi_Kenya/5750040）。