Description of tool

Discharge outcomes should also be analysed for an acceptable pattern of admissions over time alone does not guarantee good coverage. Discharge outcome includes cure rate, defaulter rate, death rate and non-response rate¹. Cure rate is calculated as: Death rate is calculated as: Non-response rate is calculated as: Defaulter rate is calculated as:  

Data requirements

Discharge outcome data can be obtained from the program's database (if available) or from the outpatient care treatment cards.  

Analysis of data

Data on discharge outcome is analysed graphically. A line graph is created either by hand or using a computer with time (in months) on the x-axis and four discharge outcomes on the y-axis. A tutorial on how to use a spreadsheet in creating a line graph can be found here and a template spreadsheet that creates a line graph for discharge outcomes over time can be found here.Since the four discharge outcomes are all proportions, the range and scale of the y-axis is from 0% to 100% for all four measures allowing for all four to be plotted onto the same line graph. An example of a computer-generated line graph of defaulters over time is shown in Figure 1 using data from a CMAM program in Somalia. Figure 1: Discharge outcomes over time _{Data courtesy of SAACID and Oxfam Novib}  

Interpretation

The Sphere Project sets the minimum standards for the discharge outcomes². Cure rates should be higher than 75% while defaulter rates should be less than 15% and death rates should be less than 10%. Figure 1 shows the minimum standards and illustrates the relationship between the four discharge outcome indicators. Death rates, non-response rates and defaulter rates should be kept as low as possible so as to get cure rates as high as possible. A program with high cure rates (hence low defaulter, death and non-response rates) is said to be an effective program. It is important to assess the effectiveness of a program in relation to its coverage because effectiveness and coverage are dependent upon the same things (as discussed here). Good coverage supports good effectiveness. Good effectiveness supports good coverage. Maximizing coverage maximises effectiveness and met need³.  

Endnotes

¹ Valid International, 2006. Community-based Therapeutic Care (CTC): A Field Manual, Oxford: Valid International. ² The Sphere Project, 2011. The Sphere Project: Humanitarian Charter and Minimum Standards in Humanitarian Response, The Sphere Project. ³ Myatt, M. et al., 2012. Semi-Quantitative Evaluation of Access and Coverage (SQUEAC)/ Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage (SLEAC) Technical Reference, Washington, DC: FHI 360/FANTA.