Anver Hamdani
Ministry of Health, Sri Lanka
Title: Improving service quality and sustainability in management of COVID 19 patients in low resourced country
Biography
Biography: Anver Hamdani
Abstract
During COVID-19 pandemic, quality of healthcare provision, health systems and patient satisfaction have been greatly affected. Low-resourced countries such as Sri Lanka, delivers free health services, faced severe shortages in financing, human resource, medicine and supplies. The health system was not prepared to encounter COVID-19 challenges. The negative impact of COVID on national economy aggravated this situation. Further, the health system was overburdened by a policy of admitting all tested positive patients for institutionalized care. Therefore, it was pivotal to evaluate the quality and sustainability of the care provided.
Above challenges faced by the health system were identified through participatory observation. The patient centered care was assessed with regards to four domains; food, sanitation, patient care and management. Data collected using an interviewer-administered questionnaire via distant communication mode, 206 participants in 55 treatment centers across Sri Lanka during March-May 2021. The level of satisfaction regarding patient care and management recorded highest compared to other domains (71%). High-risk and complicated patients were referred to specialized tertiary care. However, this process of admitting all positively tested and providing care at different levels was very resource intensive.
The isolation process and the illness led to severe stress for patients, especially among asymptomatic or mildly symptomatic. Even though overall satisfaction was high, the impact of satisfaction regarding food (64%), sanitation (63%) and patient care (71%), nevertheless overall satisfaction was less due to economic and logistical constraints. Based on the above findings, it was proposed to introduce a home-based management system for those who are asymptomatic to mild symptomatic and triage for early identification of high-risk patients. A telemedicine system was proposed for triaging and home-based management. These proposals were immediately implemented and played a major role in reducing the economic and resource burden on health system and drastically reducing morbidity and mortality during subsequent COVID waves.