1. Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data
- Author
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MacPherson, P., Squire, S. B., Cleary , P., Davies, S., Wake, C., Dee, K., Walker, J., Farrow, S., McMaster, P., Woodhead, M., Sloan, Derek James, North West TB Audit Steering Committee, and University of St Andrews. School of Medicine
- Subjects
Male ,socio-economic deprivation ,Pediatrics ,030204 cardiovascular system & hematology ,Logistic regression ,0302 clinical medicine ,Risk Factors ,RA0421 ,RA0421 Public health. Hygiene. Preventive Medicine ,Ethnicity ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Child ,Middle Aged ,Treatment Outcome ,Infectious Diseases ,patient-centred care ,England ,Child, Preschool ,Cohort ,Female ,Socio-economic deprivation ,Risk assessment ,Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,Human immunodeficiency virus test ,NDAS ,Patient-centred care ,Audit ,Young Adult ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Environmental health ,Humans ,Area of residence ,Aged ,business.industry ,Infant, Newborn ,Infant ,Original Articles ,medicine.disease ,United Kingdom ,Logistic Models ,TB cohort review ,Socioeconomic Factors ,North west ,business - 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. Publisher PDF
- Published
- 2016