TY - JOUR
T1 - Equitable tuberculosis care in the North West of England
T2 - Analysis of tuberculosis cohort review data
AU - North West TB Audit Steering Committee
AU - MacPherson, P.
AU - Squire, S. B.
AU - Cleary, Paul
AU - Davies, S.
AU - Wake, C.
AU - Dee, K.
AU - Walker, J.
AU - Farrow, S.
AU - McMaster, P.
AU - Woodhead, M.
AU - Sloan, D. J.
N1 - Publisher Copyright:
© 2016 The Union.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - 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. RESULT S : 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. CONCLUS IONS : 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 NorthWest of England is equitable. The extent to which the cohort review process contributes to, and sustains, this standard of care deserves further study.
AB - 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. RESULT S : 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. CONCLUS IONS : 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 NorthWest of England is equitable. The extent to which the cohort review process contributes to, and sustains, this standard of care deserves further study.
KW - England
KW - Patient-centred care
KW - Socio-economic deprivation
KW - TB cohort review
KW - Tuberculosis
UR - https://www.scopus.com/pages/publications/84966668507
U2 - 10.5588/ijtld.15.0772
DO - 10.5588/ijtld.15.0772
M3 - Article
C2 - 27155181
AN - SCOPUS:84966668507
SN - 1027-3719
VL - 20
SP - 778
EP - 785
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 6
ER -
