ArticlePloS one2014
Tuberculosis treatment managed by providers outside the Public Health Department: lessons for the Affordable Care Act.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Patient support for tuberculosis patients in low-incidence countries: A systematic review.PloS one · 2018Pooled it
- Characteristics of TB cases without documented sputum culture in the United States, 2011-2021.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2024Article
- Racial and ethnic disparities in diagnosis and treatment outcomes among US-born people diagnosed with tuberculosis, 2003-19: an analysis of national surveillance data.The Lancet. Public health · 2024Article
- Predictors of latent tuberculosis infection treatment completion in the US private sector: an analysis of administrative claims data.BMC public health · 2018Article
- Pediatric tuberculosis consultations across 5 CDC regional tuberculosis training and medical consultation Centers.Journal of clinical tuberculosis and other mycobacterial diseases · 2018Article
- A systematic synthesis of direct costs to treat and manage tuberculosis disease applied to California, 2015.BMC research notes · 2017Article
- Tuberculosis Knowledge, Awareness, and Stigma Among African-Americans in Three Southeastern Counties in the USA: a Qualitative Study of Community Perspectives.Journal of racial and ethnic health disparities · 2017Article
- Treatment of Active Tuberculosis in Chicago, 2008-2011: The Role of Public Health Departments.PloS one · 2016Article
- Tuberculosis Elimination Efforts in the United States in the Era of Insurance Expansion and the Affordable Care Act.Public health reports (Washington, D.C. : 1974)Article
- Tuberculosis Prevention in the Private Sector: Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment With Isoniazid Among the Commercially Insured.Journal of public health management and practice : JPHMPArticle
- Modeling the Impact of Recommendations for Primary Care-Based Screening for Latent Tuberculosis Infection in California.Public health reports (Washington, D.C. : 1974)Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTuberculosis (TB) requires at least six months of multidrug treatment and necessitates monitoring for response to treatment. Historically, public health departments (HDs) have cared for most TB patients in the United States. The Affordable Care Act (ACA) provides coverage for uninsured persons and may increase the proportion of TB patients cared for by private medical providers and other providers outside HDs (PMPs). We sought to determine whether there were differences in care provided by HDs and PMPs to inform public health planning under the ACA.
methodsWe conducted a retrospective, cross-sectional analysis of California TB registry data. We included adult TB patients with culture-positive, pulmonary TB reported in California during 2007-2011. We examined trends, described case characteristics, and created multivariate models measuring two standards of TB care in PMP- and HD-managed patients: documented culture conversion within 60 days, and use of directly observed therapy (DOT).
resultsThe proportion of PMP-managed TB patients increased during 2007-2011 (p = 0.002). On univariable analysis (N = 4,606), older age, white, black or Asian/Pacific Islander race, and birth in the United States were significantly associated with PMP care (p<0.05). Younger age, Hispanic ethnicity, homelessness, drug or alcohol use, and cavitary and/or smear-positive TB disease, were associated with HD care. Multivariable analysis showed PMP care was associated with lack of documented culture conversion (adjusted relative risk [aRR] = 1.37, confidence interval [CI] 1.25-1.51) and lack of DOT (aRR = 8.56, CI 6.59-11.1).
conclusionWhile HDs cared for TB cases with more social and clinical complexities, patients under PMP care were less likely to receive DOT and have documented culture conversion. This indicates a need for close collaboration between PMPs and HDs to ensure that optimal care is provided to all TB patients and TB transmission is halted. Strategies to enhance collaboration between HDs and PMPs should be included in ACA implementation.
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