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Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data
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 co...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Union Against Tuberculosis and Lung Disease
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857719/ https://www.ncbi.nlm.nih.gov/pubmed/27155181 http://dx.doi.org/10.5588/ijtld.15.0772 |
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author | MacPherson, P. Squire, S. B. Cleary, P. Davies, S. Wake, C. Dee, K. Walker, J. Farrow, S. McMaster, P. Woodhead, M. Sloan, D. J. |
author_facet | MacPherson, P. Squire, S. B. Cleary, P. Davies, S. Wake, C. Dee, K. Walker, J. Farrow, S. McMaster, P. Woodhead, M. Sloan, D. J. |
author_sort | MacPherson, P. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4857719 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | International Union Against Tuberculosis and Lung Disease |
record_format | MEDLINE/PubMed |
spelling | pubmed-48577192016-06-01 Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data MacPherson, P. Squire, S. B. Cleary, P. Davies, S. Wake, C. Dee, K. Walker, J. Farrow, S. McMaster, P. Woodhead, M. Sloan, D. J. Int J Tuberc Lung Dis Original Articles 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. International Union Against Tuberculosis and Lung Disease 2016-06 2016-06-01 /pmc/articles/PMC4857719/ /pubmed/27155181 http://dx.doi.org/10.5588/ijtld.15.0772 Text en © 2016 MacPherson et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Articles MacPherson, P. Squire, S. B. Cleary, P. Davies, S. Wake, C. Dee, K. Walker, J. Farrow, S. McMaster, P. Woodhead, M. Sloan, D. J. Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data |
title | Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data |
title_full | Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data |
title_fullStr | Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data |
title_full_unstemmed | Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data |
title_short | Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data |
title_sort | equitable tuberculosis care in the north west of england: analysis of tuberculosis cohort review data |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857719/ https://www.ncbi.nlm.nih.gov/pubmed/27155181 http://dx.doi.org/10.5588/ijtld.15.0772 |
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