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THE INITIAL RESULTS OF INTEGRATED ARV-MMT IN PREVENTIVE MEDICINE CENTERS IN HCMC

THE INITIAL RESULTS OF INTEGRATED ARV-MMT IN PREVENTIVE MEDICINE CENTERS IN HCMC. Tieu Thi Thu Van, Nguyen Thi Thuy Nga, Đinh Quoc Thong, Le Thi Ngoc Diep, Mai Thi Hoai Son, Nguyen Thi Thu Thao, Van Hung HCMC AIDS Committee. Outline. Background Objectives Methods Results & Discussions

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THE INITIAL RESULTS OF INTEGRATED ARV-MMT IN PREVENTIVE MEDICINE CENTERS IN HCMC

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  1. THE INITIAL RESULTS OF INTEGRATED ARV-MMT IN PREVENTIVE MEDICINE CENTERS IN HCMC Tieu Thi Thu Van, Nguyen Thi Thuy Nga, Đinh Quoc Thong, Le Thi Ngoc Diep, Mai Thi Hoai Son, Nguyen Thi Thu Thao, Van Hung HCMC AIDS Committee

  2. Outline Background Objectives Methods Results & Discussions Conclusions Recommendations

  3. 1. Background • Dec., 2014, HCMC has: • 33 OPC for ARV (24 OPC located in PMC at 24 districts, 5 OPC located in hospitals and 4 OPC in 06 Centers) with 24,638 ARV patients; • 8 MMT clinics in district PMC with 2,013 MMT patients. • By 2012, most of activities and services in MMT clinics and OPCs were funded by NGOs (PEPFAR, Global Fund, DEFID, World Bank…).

  4. 1. Background • Since 2012, the funding is decreasing  starting transferring process to the local (activities and budget). • Need to integrate all HIV related services in the clinics, streamline the system to improve working efficiency and ensure to remain the program results and the program sustainable development. • Need to do assessment to identify the effectiveness and feasibility of the integrated model, then provide suitable solutions and orientation for the program development in HCMC in the future.

  5. 1. Background D. COUNSELING AND COMMUNITY SUPPORT OPC MMT Clinic Admin Admin Medical Medical Counseling Conseling Testing Testing Medicine delivery Medicine delivery By Oct.,2013, the MMT clinics and the OPC had separately facilities, equipment, budget and staff.

  6. Admin (reception, patient classification) 1 4 2 Medicine (MMT, ARV) Counseling (HTC, MMT, ARV) Medical (MMT, ARV) 4 5 1. Background 3 Testing (urine, blood) 6 7 The diagram of patient classification in integrated model

  7. 2. Objectives “Assess the results of integrated ARV-MMT treatment in Preventive Medicine Centers in HCMC” • Specific: • Comparing working efficiency of clinic staff before and after integrated • Comparing cost of clinic’s operation before and after integrated. • Comparing the program monitoring results of ARV and MMT treatment before and after integrated.

  8. 3. Methods Research design: Cross sectional study Time: Before integrating: From Mar. to Sep., 2013; After integrating: from Jul. to Dec., 2014 Research place: OPC and MMT clinics in D.6 and BinhThanh. Research population: MMT and ARV staff and patients of the clinics in the 2 districts..

  9. 3. Methods • Research sample: • Working efficiency: • Cost: All operation cost by cash for the clinics activities in 6 months before and after the integration • Activity results: ARV: 5 HIVQUAL indicators; MTD: 6 monitoring indicators

  10. 3. Methods Analysis methods: Descriptive statistic and then used comparing analysis to understand about the data (excel, SPSS sata 13.)

  11. 4. Results & Discussions After integrated, the number staff was cut down in both program, particularly ARV. Clinic staff before and after integrating model

  12. 4. Results & Discussions After integrated, staff’s working time was increased quite high because of the staff was trained to work with multiduties. Working time of the clinic staff before and after integration

  13. 4. Results & Discussions ARV patients: after integrated, time for waiting and receive the the service (ARV/MMT) were decreased but ART patients have to spend more time to wait. Waiting and receiving the service of ARV/MMT patients

  14. 4. Results & Discussions MMT patients: after the integration, patient time for waiting and receiving the service was reduced. Thời gian chờ và nhận DV của BN Methadone trước và sau lồng ghép

  15. 4. Results & Discussions After integrated: • Cost was go down • The number of patients was go up Summary of cost and number of enrolled patients before and after the integrated

  16. 4. Results & Discussions

  17. 4. Results & Discussions All most of the indicators did not show any affected by the integrated ARV-MMT services

  18. 5. Conclusions The limitation of integrated model: • The staff was put at risk of workload. • The service quality was put at risk of go down because doctors and staff did not have enough time for patients to support their needs.

  19. 5. Conclusions Benefical of the integrated model: • Improve staff effective working • Save cost for operation and staff through restructured system and have reasonable allocative jobs. • In generally, the integrated model has not any affective to the results of the 2 clincs.

  20. 6. Recommendations The integrative model was cost saving, Mô hình lồng ghép hiệu quả, tiết kiệm, giúp đảm bảo được sự bền vững của CT vì tận dụng được các nguồn lực sẵn có cần được xem xét nhân rộng. The integrative model should incorporative, streamlined, professional and appropriate assignment to ensure both quality cost and effectiveness expenditure.

  21. QUESTION?THANK YOU!

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