Journal of Acquired Immune Deficiency Syndromes | September 2015
Late delivery of test results is likely to be associated with patient loss to follow-up in HIV early infant diagnosis (EID) programs in resource-limited settings.
Methods: We used EID program data collected during a pilot implementation of an expedited results delivery system(ERDS) using GPRS printers in Mozambique from 2009 through 2010. Our dataset comprised 1,757 patient records, of which 767 were from before and 990 from after implementation of ERDS.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 collectionof results by the caregiver.
Results:The mean test turnaround timereduced from 68.13 to 41.05 days post-ERDS. Of the 1,757 results, only 665 (37.8%) were collected by caregivers.After controlling for confounders, the late delivery of resultswas associated with a reduction of approximately 18% (0.44 vs. 0.36; p-value<0.01) in the probability of results collected by thecaregivers (OR=0.67, p-value<0.05). Late delivery of results was also associated with a further average increase in 20.91 daysof delay in collection of results (p-value<0.01).
Conclusions: Late delivery of results is associated with lower probability of them being collected and a further increase in communication delay. EID programs should further evaluate the cost-effectiveness of operational interventions(e.g. GPRS printers) that reduce delays.
Sarang Deo is a Professor of Operations Management at the Indian School of Business (ISB). He also serves as the Executive Director of the ISB’s Max Institute of Healthcare Management, where he provides strategic leadership for ISB's healthcare initiatives through interdisciplinary research, education, and collaboration.
Professor Deo's research focuses on healthcare delivery systems, examining how operational decisions influence population-level health outcomes. His work spans a wide range of healthcare contexts, including influenza vaccine supply chains and ambulance diversion in the United States, HIV early infant diagnosis networks in sub-Saharan Africa, and formal and informal pathways for tuberculosis (TB) diagnosis and treatment in India. His recent research has focused on designing and evaluating healthcare delivery models, with a particular emphasis on digital health and the integration of artificial intelligence into healthcare systems.
He regularly collaborates with leading global health organisations, including the Gates Foundation, the Clinton Health Access Initiative (CHAI), and PATH. He currently serves on the World Health Organization's Strategic and Technical Advisory Group for Tuberculosis (STAG-TB) and the Working Group for Non-Technical Evaluation under the WHO Global Initiative on AI for Health (GI-AI4H).
Prior to joining ISB, Professor Deo was an Assistant Professor at the Kellogg School of Management. He holds a PhD from the UCLA Anderson School of Management, an MBA from the Indian Institute of Management Ahmedabad, and a BTech from the Indian Institute of Technology Bombay. Before entering academia, he worked as a management consultant with Accenture.
