Thesis (M.Sc.)--Chulalongkorn University, 2008

The objectives of this study were 1) to explore the completeness of HIV/AIDS patients care databases in community hospitals, 2) to assess quality of care in HIV/AIDS patients by the HIVQUAL-T program version 4.0 in HIV/AIDS patients, based on the guidelines of National Health Security Office for HIV/AIDS management, and 3) to propose a strategy for the continuous improvement of quality of care in HIV/AIDS patients. The study assessed the completeness of HIV/AIDS patient’s data in the NAPHA program and medical record from community hospitals during October 2006 to September 2007. The study also conducted a group meeting of the representation of ARV team in community hospitals to propose a strategy to improve quality of care of HIV/AIDS patients. The results showed that only 6 from 26 hospitals updated and completed data which covered all 7 indicators. There were 262 HIV/AIDS patients including 138 females and 124 males. All of them received ARV drugs. After assessing quality of care by HIVQUAL-T, 37.4% of patients had CD4 counts monitored once a year, 43.5% of patients had CD4 counts checked at least twice a year, 1.91% patients had viral load monitored once a year. For OI prophylaxis, 95% of patients received PCP prophylaxis and 83% of patients received Cryptococcosis prophylaxis. None of them received MAC prophylaxis. All patients with TB received TB treatment but none of them had a PPD skin test during the study. Only 6.49% of patients had a VDRL test for syphilis screening and 10.87% of female HIV/AIDS patients received PAP smear screening. The results of overall quality assessments were reviewed by the representative of ARV team in community hospitals to propose a strategy to improve quality of care of the HIV/AIDS patients. They proposed to have the individual patient record form that gathered all HIV care data. They also proposed the systematic management of quality of care assessment, to encourage HIV/AIDS patients to participate in quality assessment monitoring, and continuous quality of care assessment by the ARV team.