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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/4339


    Title: Reduced health provider delay and tuberculosis mortality due to an improved hospital programme
    Authors: Liu, YC;Lin, HH;Chen, YS;Su, IJ;Huang, TS;Tsai, HC;Wann, SR;Lee, SSJ
    Contributors: Division of Infectious Diseases
    Abstract: SETTING: A referral hospital in Kaohsiung, Taiwan. OBJECTIVE: To evaluate the impact of an in-hospital tuberculosis (TB) quality care programme initiated in May 2005 on health provider delay and outcome of newly diagnosed TB cases. DESIGN: Retrospective chart review of newly diagnosed TB cases presenting in 2002 and 2006. Health provider delay, clinical manifestations, management and outcome were recorded. RESULTS: Overall, 327 patients before (2002) and 262 patients after (2006) the programme began were enrolled. Patients were older men (mean age 65.9 years) and 23.4% (138/589) had diabetes; 84.4% had received anti-tuberculosis treatment. The programme shortened the time for doctors to order a chest X-ray (P < 0.01), and the reporting time for smear (P < 0.0001) and culture (P < 0.0001). On multivariable analysis, risk factors for attributable mortality included age >= 65 years (OR 4.4, 95%CI 1.8-10.9, P = 0.001) and liver cirrhosis (OR 4.3, 95%CI 1.1-16.6, P = 0.04). Treatment reduced mortality by 81% (OR 0.2, 95%CI 0.1-0.4, P < 0.001) and the programme halved overall mortality (OR 0.5, 95%CI 0.3-0.8, P = 0.01), and reduced attributable mortality by 62% (OR 0.4, 95%CI 0.2-0.8, P < 0.01). CONCLUSION: Intervention at the hospital level for quality control of TB care was instrumental in reducing health provider delay and led to a significant reduction in mortality.
    Date: 2010-01
    Relation: International Journal of Tuberculosis and Lung Disease. 2010 Jan;14(1):72-78.
    Link to: http://www.ingentaconnect.com/content/iuatld/ijtld/2010/00000014/00000001/art00012?token=005314bda11f383a4b3b2570497b455f416a5e2c3a46562a726e2d2954496f642f466fcc9b04d1a6961
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1027-3719&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000273311700012
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=76149115257
    Appears in Collections:[蘇益仁(2002-2015)] 期刊論文

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