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Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data.

MacPherson, Peter ORCID: https://orcid.org/0000-0002-0329-9613, Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038, Cleary, P, Davies, S, Wake, Carolyn, Dee, K, Walker, J, Farrow, S, McMaster, P, Woodhead, M and Sloan, Derek (2016) 'Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data.'. International Journal of Tuberculosis and Lung Disease, Vol 20, Issue 6, pp. 778-85.

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Abstract

BACKGROUND
In the United Kingdom, tuberculosis (TB) predominantly affects the most deprived populations, yet the extent to which deprivation affects TB care outcomes is unknown.

METHODS
Since 2011, the North West TB Cohort Audit collaboration has undertaken quarterly reviews of outcomes against consensus-defined care standard indicators for all individuals notified with TB. We investigated associations between adverse TB care outcomes and Index of Multiple Deprivation (IMD) 2010 scores measured at lower super output area of residence using logistic regression models.

RESULTS
Of 1831 individuals notified with TB between 2011 and 2014, 62% (1131/1831) came from the most deprived national quintile areas. In single variable analysis, greater deprivation was significantly associated with increased likelihood of the completion of a standardised risk assessment (OR 2.99, 95%CI 5.27-19.65) and offer of a human immunodeficiency virus test (OR 1.72, 95%CI 1.10-2.62). In multivariable analysis, there were no significant associations.

CONCLUSIONS
TB patients in the most deprived areas had similar care indicators across a range of standards to those of individuals living in the more affluent areas, suggesting that the delivery of TB care in the North West of England is equitable. The extent to which the cohort review process contributes to, and sustains, this standard of care deserves further study.

Item Type: Article
Subjects: W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.15.0772
Depositing User: Jessica Jones
Date Deposited: 01 Jun 2016 09:55
Last Modified: 12 Jul 2018 15:26
URI: https://archive.lstmed.ac.uk/id/eprint/5909

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