title: Implementation and Operational Research: Expedited Results Delivery Systems Using GPRS Technology Significantly Reduce Early Infant Diagnosis Test Turnaround Times.
abstract: The objective of this study was to quantify the impact of a new technology to communicate the results of an infant HIV diagnostic test on test turnaround time and to quantify the association between late delivery of test results and patient loss to follow-up. We used data collected during a pilot implementation of Global Package Radio Service (GPRS) printers for communicating results in the early infant diagnosis program in Mozambique from 2008 through 2010. Our dataset comprised 1757 patient records, of which 767 were from before implementation and 990 from after implementation of expedited results delivery system. We used multivariate logistic regression model to determine the association between late result delivery (more than 30 days between sample collection and result delivery to the health facility) and the probability of result collection by the infant's caregiver. We used a sample selection model to determine the association between late result delivery to the facility and further delay in collection of results by the caregiver. The mean test turnaround time reduced from 68.13 to 41.05 days post-expedited results delivery system. Caregivers collected only 665 (37.8%) of the 1757 results. After controlling for confounders, the late delivery of results was associated with a reduction of approximately 18% (0.44 vs. 0.36; P < 0.01) in the probability of results collected by the caregivers (odds ratio = 0.67, P < 0.05). Late delivery of results was also associated with a further average increase in 20.91 days of delay in collection of results (P < 0.01). Early infant diagnosis program managers should further evaluate the cost-effectiveness of operational interventions (eg, GPRS printers) that reduce delays.
authors.affiliation: *Indian School of Business, Hyderabad, India; †Clinton Health Access Initiative, Maputo, Mozambique; and ‡Instituto Nacional da Saude, Maputo, Mozambique.
authors.forename: Sarang
authors.initials: S
authors.lastname: Deo
authors.forename: Lindy
authors.initials: L
authors.lastname: Crea
authors.forename: Jorge
authors.initials: J
authors.lastname: Quevedo
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lehe
authors.forename: Lara
authors.initials: L
authors.lastname: Vojnov
authors.forename: Trevor
authors.initials: T
authors.lastname: Peter
authors.forename: Ilesh
authors.initials: I
authors.lastname: Jani
mesh_terms: D057210:Delayed Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D063025:Health Information Management / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059012:Lost to Follow-Up; D008297:Male; D009073:Mozambique; D011845:Radio; D017216:Telemedicine / Q000379:methods*; D013997:Time Factors