Median health care delay 24 days for tuberculosis patients in U.S..


Median health care delay 24 days for TB patients in united states

The median health care delay for patients with tuberculosis (TB) in the United States is 24 days, according to a study published online March 23 in The Lancet Infectious Diseases.

Jessica El Halabi, M.D., from Harvard Medical School in Boston, and colleagues conducted a retrospective, observational cohort study measuring U.S. TB health care delays between 2008 and 2016 based on repurposed private insurance claims data (Aetna).

The researchers confirmed 738 active TB cases, which had a median health care delay of 24 days (interquartile range, 10 to 45 days). Longer delays correlated with older age (8.4 percent longer delay per 10-year increase in age) and with non-HIV immunosuppression (19.2 percent) in a multivariable analysis. Relative to presenting with one symptom, presenting with three or more symptoms correlated with shorter delays (−22.5 percent). Shorter delays were also seen in association with the use of chest imaging, a TB nucleic acid amplification test, or care by a TB specialist provider (−24.9, −19.2, and −17.2 percent, respectively). Even after adjustment for patient characteristics and a higher rate of secondary TB among dependents, longer delays correlated with a higher rate of respiratory complications.

“Our findings point to the key importance of continuing education of providers. We found several factors associated with delays and faster diagnosis,” a coauthor said in a statement. “This tells us that delays are modifiable and preventable.”

One author disclosed financial ties to Aetna; one disclosed ties to Aetna Life Insurance Company.


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