Table 2 Proposed scorecard of program-level quality measures
From: Improving HIV outcomes in resource-limited countries: the importance of quality indicators
STEP ALONG CONTINUUM | MEASURE |
|---|---|
a) HIV Testing and Diagnosis | â–ª% of patients diagnosed on site [P] |
| Â | â–ª% of patients diagnosed in other medical facilities [P] |
| Â | â–ª% of patients diagnosed via home-based test [P] |
| Â | â–ª% of patients diagnosed in mobile testing unit [P] |
| Â | â–ª% of couples whose partners have been HIV tested and are aware of results [P] |
b) Linkage to Care | â–ª Median days from HIV diagnosis to referral for ART or pre-ART care [P] |
|  | ▪% of patients ART ineligible at baseline who receive a follow-up CD4 count in 6 months [P] |
| Â | â–ª Median days from clinic enrollment to ART eligibility [P] |
|  | ▪% of patients who are enrolled in HIV clinic, received CD4 count & results within 3 months of HIV diagnosis [P] |
|  | ▪% of patients with CD4 count ≤ 200 cells/uL, & ≤ 350 cells/uL at presentation [P] |
c) ART Eligibility: Clinical, Laboratory & Psychosocial Assessment | â–ª% of patients screened for tuberculosis [P] |
| Â | â–ª% of eligible patients provided with nutritional supplementation [P] |
| Â | â–ª% of ART-eligible patients who died before ART initiation [O] |
d) ART Preparation: Literacy Training, OI Prophylaxis, and Adherence Assessment | â–ª Median days from enrollment to ART initiation for eligible patients [P] |
| Â | â–ª Median days from enrollment to completion of ART literacy training for eligible patients [P] |
e) ART Initiation | â–ª # drug stock outs in last quarter for first-line ART drugs or cotrimoxazole [P] |
| Â | â–ª Local guideline concordance (e.g. CD4 testing, adherence monitoring, assessment for drug toxicity, OI screening & prophylaxis) [P] |
f) Retention in Care | ▪% of patients retained in care 6 and 12 months from enrollment (ART eligible and ART-ineligible) [O] |
|  | ▪% of patients who transferred care to other clinics 6 and 12 months from enrollment [O] |
| Â | â–ª% of patients deemed lost to follow-up who have been contacted by clinic staff to determine outcome [O] |
g) Clinical Outcomes | ▪% of patients on ART with undetectable viral load at 12 months [O] |
|  | ▪% of patients on ART requiring switch to second-line therapy for treatment failure at 12 and 24 months [O] |
|  | ▪% of patients (ART-eligible on and off ART) who died 12 months after enrollment [O] |
h) Patient Reported Outcomes | ▪ patient-reported health status 6 and 12 months after clinic enrollment [O] |