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

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Date
01/06/2016
Author
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
Keywords
England
TB cohort review
Patient-centred care
Socio-economic deprivation
Tuberculosis
RA0421 Public health. Hygiene. Preventive Medicine
NDAS
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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.
Citation
MacPherson , P , Squire , S B , Cleary , P , Davies , S , Wake , C , Dee , K , Walker , J , Farrow , S , McMaster , P , Woodhead , M , Sloan , D J & North West TB Audit Steering Committee 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 , no. 6 , pp. 778-785 . https://doi.org/10.5588/ijtld.15.0772
Publication
International Journal of Tuberculosis and Lung Disease
Status
Peer reviewed
DOI
https://doi.org/10.5588/ijtld.15.0772
ISSN
1027-3719
Type
Journal article
Rights
© 2016 MacPherson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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  • Medicine Research
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/8789

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