Cross-Sectional Survey of Haemophilia Treatment Centres (HTCs) in India: Towards a Context‑Sensitive Stratification Model

IF 3 2区医学 Q2 HEMATOLOGY

Haemophilia Pub Date : 2025-07-29 DOI:10.1111/hae.70095

M Joseph John, Chandrakala Shanmukhaiah, Toshirenla Aier, Neeraj Sidharthan, Renu Saxena, Shashikant Apte, Aby Abraham, Naresh Gupta, Soniya Nityanand, Cecil Ross, Tulika Seth, Alok Srivastava

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Abstract

Introduction

Haemophilia treatment centres (HTCs) coordinate multidisciplinary care, yet the European HTC standards on which global accreditation systems really do not reflect the wide resource gradient found in India.

Aim

To assess HTC capacities across India and explore a tiered stratification model suited to diverse settings.

Methods

A nationwide, self‑administered survey (February 2021–April 2022) was e‑mailed to all 291 HTCs registered with the Indian Association of Haemophilia and Allied Disorders. It captured infrastructure, laboratory capability and clinical services. Descriptive statistics and Spearman correlation were applied.

Results

Ninety centres (30%) responded from 24 states/UTs. Only 34% fulfilled European HTC (EHTC) criteria and 11% met comprehensive‑care (EHCCC) criteria; 55% were unclassified despite providing haemophilia care. Laboratory‑to‑clinical functionality showed a moderate correlation (r = 0.61, p < 0.001). Twenty‑seven percent of centres operated without an onsite coagulation laboratory, whereas 40% lacked full‑time nurses and 60% lacked multidisciplinary teams. Factor VIII/IX supplies were uninterrupted at 31% of sites; 38% offered prophylaxis to at least one patient.

Conclusion

Rigid European categories mask the stepwise growth of Indian HTCs. A four‑tier model—anchored in predefined criteria for clinical and laboratory services could guide incremental upgrading while preserving patient safety.

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血友病治疗中心（HTCs）在印度的横断面调查：朝着上下文敏感分层模型。

血友病治疗中心（HTC）协调多学科护理，然而，全球认证系统所依据的欧洲HTC标准确实没有反映出印度广泛的资源梯度。目的：评估整个印度的HTC产能，并探索适合不同环境的分层分层模型。方法：一项全国性的自我管理调查（2021年2月至2022年4月）通过电子邮件发送给在印度血友病及相关疾病协会注册的所有291名HTCs。它涵盖了基础设施、实验室能力和临床服务。采用描述性统计和Spearman相关分析。结果：来自24个州/ ut的90个中心（30%）做出了回应。只有34%符合欧洲HTC （EHTC）标准，11%符合综合护理（EHCCC）标准；55%的患者尽管提供了血友病治疗，但仍未分类。实验室-临床功能显示中度相关性（r = 0.61, p）。结论：僵化的欧洲分类掩盖了印度HTCs的逐步增长。以临床和实验室服务的预定义标准为基础的四层模型可以指导逐步升级，同时保护患者安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Haemophilia 医学-血液学

CiteScore

6.50

自引率

28.20%

发文量

226

审稿时长

3-6 weeks

期刊介绍： Haemophilia is an international journal dedicated to the exchange of information regarding the comprehensive care of haemophilia. The Journal contains review articles, original scientific papers and case reports related to haemophilia care, with frequent supplements. Subjects covered include: clotting factor deficiencies, both inherited and acquired: haemophilia A, B, von Willebrand''s disease, deficiencies of factor V, VII, X and XI replacement therapy for clotting factor deficiencies component therapy in the developing world transfusion transmitted disease haemophilia care and paediatrics, orthopaedics, gynaecology and obstetrics nursing laboratory diagnosis carrier detection psycho-social concerns economic issues audit inherited platelet disorders.