ArticleBMC infectious diseases2015
Health system delay among patients with tuberculosis in Taiwan: 2003-2010.
Article in BMC infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04433195 (Xpert MTB/RIF Test as the Initial Diagnostic Test in the Diagnosis of Pulmonary Tuberculosis), which is not on this map. Cited by 14 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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Xpert MTB/RIF Test as the Initial Diagnostic Test in the Diagnosis of Pulmonary Tuberculosis: a Pragmatic Trial
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis.BMC pulmonary medicine · 2017Pooled it
- Article
- Reduced risk of dementia in patients with type 2 diabetes mellitus using Chinese herbal medicine: A nested case-control study.World journal of diabetes · 2023Article
- Uncovering reasons for treatment initiation delays among children with TB in Lima, Peru.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2020Article
- Patient pathways of tuberculosis care-seeking and treatment: an individual-level analysis of National Health Insurance data in Taiwan.BMJ global health · 2020Article
- Patient and health care system characteristics are associated with delayed treatment of tuberculosis cases in Taiwan.BMC health services research · 2019Article
- Delay in tuberculosis diagnosis and treatment in Amhara state, Ethiopia.BMC health services research · 2019Article
- Tuberculosis among Full-Time Teachers in Southeast China, 2005⁻2016.International journal of environmental research and public health · 2018Article
- Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study.BMC public health · 2018Article
- The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran.BMC public health · 2018Article
- Treatment initiation among persons diagnosed with drug resistant tuberculosis in Johannesburg, South Africa.PloS one · 2017Article
- Patients' and health system's delays in the diagnosis and treatment of new pulmonary tuberculosis patients in West Gojjam Zone, Northwest Ethiopia: a cross-sectional study.BMC infectious diseases · 2016Article
- Glycemic Control and the Risk of Tuberculosis: A Cohort Study.PLoS medicine · 2016Article
- Health Care Visits as a Risk Factor for Tuberculosis in Taiwan: A Population-Based Case-Control Study.American journal of public health · 2016Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTaiwan has integrated the previous vertical tuberculosis (TB) control system into the general health care system. With the phase out of the specialized TB care system and the declining TB incidence, it is likely that clinical workers become less familiar with the presentation of TB, resulting in delay in TB diagnosis and treatment.
methodsWe used the detailed information of health care visits in the Taiwan National Health Insurance database to analyze the temporal pattern of the health system delay (HSD) among 3,117 patients with TB between 2003 and 2010.
resultsThe median HSD was 29 days (interquartile range 5-73 days), and the median delay increased from 26 days in 2003 to 33.5 days in 2008, thereafter slightly decreased to 32 days in 2010. Patient factors associated with a longer HSD included: aged 45-64 and ≧65 years (as compared to aged <30 years); females (as compared to males); an initial visit as an outpatient (as compared to an inpatient). Provider factors were an initial visit to a provider not specialized in TB (as compared to a TB-related provider), to a primary care clinic or to a medical center (as compared to a district hospital), and in Central region, Northern region, KaoPing region, Southern region and Taipei region (as compared to in Eastern region). Longer distances from the point of initial visit to that of treatment were associated with longer HSD. Patients who switched among different levels or different types of medical care services during their illness exhibited the longest HSD.
conclusionsIn countries where the TB care systems are being restructured from a vertical to a horizontal system, it is critical to monitor HSD and be aware of its increase. The potential increase in the HSD from 2003 to 2008 observed in this study is concerning and the decline of HSD after 2008 might be attributed to the launch of contact investigation. Our results call for actions to improve the efficiency of TB diagnosis in the health care system and to increase the awareness of TB among physicians and the general public.
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