Quality Improvement of Tuberculosis Management in Buri Ram Hospital (2007-2008) - การพัฒนาคุณภาพการรักษาวัณโรคในบริบทโรงพยาบาลบุรีรัมย์ (2550-2551)

บทคัดย่อ

       The World Health Organization declared tuberculosis (TB) a global public health emergency, recognizing its enormous, rising and far-reaching burden of disease. Thailand was 18 in 22 of highburden country. In 2007, there was 192 tuberculosis patients in Buri Ram hospital that were pulmonary tuberculosis with smear-positive in 132 cases, pulmonary tuberculosis with smear-negative in 41 cases, and extrapulmonary tuberculosis in 19 cases. Eventhough a success rate was more than 87.4 percent, it underlined problems of default rate, spreading of the disease and 8 fatal cases.

       The objective of this action research was to study quality improvement of this of tuberculosis management 2007 to 2008 and planning for upcoming management of tuberculosis. The patients who were diagnosed of tuberculosis and undergoing treatment at Buri Ram Hospital between October 2007 and September 2008 were included based on their medical records. The action research was divided into three phases-a situation analysis, a planing and development of standard medical treatment system and an evaluation. In the last phase in September 2008, a focus was made on assessment of number of TB patients under care, their treatment procedure and system and contact investigation to identify and control latent tuberculosis infection. Recommendations on quality improvement of tuberculosis management emerged as a result of data analysis, employing descriptive statistics. Among 202 tuberculosis patients, there were 172 pulmonary tuberculosis (85.15%) and smearpositive in 142 cases (82.56%). Showing an increase of 44 cases (25.58%) from that of the previous year.

      Of these 142 cases undergoing DOT (Directly Observed Treatment), 69 actually had relatives overseeing drug administering. In due process, contact investigation yielded 1 active pulmonary tuberculosis and 15 cases of latent tuberculosis infection. And all of them received standard treatment. Based on the criteria of the World Health Organization, the treatment outcome was not yet totally satisfactory yet the contact investigation and standard treatment that followed were effective. More improvements are planned for the upcoming year.

Key words: DOT, tuberculosis