ArticleBMJ global health2020
Patient pathways of tuberculosis care-seeking and treatment: an individual-level analysis of National Health Insurance data in Taiwan.
Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- "Fragmented care pathway in a layered TB care system": a grounded theory approach to understand care pathways and delays in TB care in Odisha.BMC health services research · 2026Article
- Enhancing TB case detection: a case study of Kenya's Global Fund-supported public-private mix.Public health action · 2026Article
- Delays in tuberculosis diagnosis and treatment in India: A patient journey analysis from Mumbai and Patna during the COVID-19 Pandemic.PLOS global public health · 2026Article
- Care-seeking and treatment pathways of multidrug-resistant tuberculosis patients: an analysis of real-world data from regional health information system in Ningbo City in Eastern China.Annals of medicine · 2025Article
- Healthcare-seeking pathway and delay analysis of rifampicin-resistant tuberculosis patient in Southwestern China.BMC public health · 2025Article
- A methodological review of patient healthcare-seeking journeys from symptom onset to receipt of care.BMJ global health · 2025Review
- Understanding treatment initiation pathways and associated costs among people with pulmonary tuberculosis in a peri-urban area of Mozambique: a cross-sectional study.BMC public health · 2025Article
- The influence of provider payment mechanisms on TB service provider behavior in Indonesia: insights from National Health Insurance data and provider perspectives.Frontiers in public health · 2025Article
- Mapping Patient Pathways in Tuberculosis Care: Insights From Gujarat and Jharkhand States of India.Cureus · 2024Article
- Individual journeys to tuberculosis care in Nigeria's private sector during the COVID-19 pandemic.BMJ global health · 2024Article
- Costs incurred by people receiving tuberculosis treatment in low-income and middle-income countries: a meta-regression analysis.The Lancet. Global health · 2023Article
- Analytical methods for identifying sequences of utilization in health data: a scoping review.BMC medical research methodology · 2023Article
- Article
- A machine learning approach to explore individual risk factors for tuberculosis treatment non-adherence in Mukono district.PLOS global public health · 2023Article
- Costs of Tuberculosis at 3 Treatment Centers, Canada, 2010-2016.Emerging infectious diseases · 2022Article
- Patient-Pathway Analysis of Tuberculosis Services in Cameroon.Tropical medicine and infectious disease · 2021Article
- Oral anti-tuberculosis drugs: An urgent medication reconciliation at hospitals in Indonesia.Journal of public health research · 2021Article
- Contributing Factors in the Tuberculosis Care Cascade in India: A Systematic Literature Review.Risk management and healthcare policy · 2021Review
- Patient pathways and delays to diagnosis and treatment of tuberculosis in an urban setting in Indonesia.The Lancet regional health. Western Pacific · 2020Article
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5 authors.
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Abstract
introductionPatients with tuberculosis (TB) often experience difficulties in accessing diagnosis and treatment. Patient pathway analysis identifies mismatches between TB patient care-seeking patterns and service coverage, but to date, studies have only employed cross-sectional aggregate data.
methodsWe developed an algorithmic approach to analyse and interpret patient-level routine data on healthcare use and to construct patients' pathways from initial care-seeking to treatment outcome. We applied this to patients with TB in a simple random sample of one million patients' records in the Taiwan National Health Insurance database. We analysed heterogeneity in pathway patterns, delays, service coverage and patient flows between different health system levels.
resultsWe constructed 7255 pathways for 6258 patients. Patients most commonly initially sought care at the primary clinic level, where the capacity for diagnosing TB patients was 12%, before eventually initiating treatment at higher levels. Patient pathways are extremely heterogeneous prior to diagnosis, with the 10% most complex pathways accounting for 48% of all clinical encounters, and 55% of those pathways yet to initiate treatment after a year. Extended consideration of alternative diagnoses was more common for patients aged 65 years or older and for patients with chronic lung disease.
conclusionOur study demonstrates that longitudinal analysis of routine individual-level healthcare data can be used to generate a detailed picture of TB care-seeking pathways. This allows an understanding of several temporal aspects of care pathways, including lead times to care and the variability in patient pathways.
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