Health system delay among patients with TB in Taiwan

Chen, C.C., Chiang, C.Y., Pan, S.C., Wang, J.Y. and Lin, H.H., 2015. Health system delay among patients with tuberculosis in Taiwan: 2003–2010. BMC infectious diseases, 15, pp.1-9.
  • TB diagnosis in Taiwan largely relies on detecting symptomatic patients, enhanced by contact tracing and active screening in high-risk groups.
  • Health care workers might miss TB due to its non-specific symptoms, increasing the risk of delayed diagnosis and transmission.
  • The decline in TB incidence and less frequent encounters with TB cases might make clinicians less proficient in recognizing the disease.
  • Health System Delay (HSD) is the time from the first consultation for respiratory issues to the start of TB treatment.
  • HSD has potentially increased from 2003 to 2008 due to various factors like the complexity of diagnosing TB and changes in the health care system.
  • Factors affecting HSD include the patient’s age, gender, type of health facility visited, and regional healthcare provider density.
  • Patients first consulting at primary care clinics, or those visiting non-TB specialists, tend to experience longer HSDs.
  • Long travel distances to treatment facilities and "doctor shopping" behavior also contribute to extended HSD.
  • Medical centers often see longer HSDs due to higher rates of comorbidities complicating TB diagnosis compared to district hospitals.
  • Female patients and the elderly might experience different HSDs due to earlier or subtler presentation of symptoms.
  • Regions like Eastern Taiwan showed surprisingly short HSDs, likely due to higher density of TB-specialized providers.
  • The analysis indicated significant regional variations in HSD, affected by medical infrastructure and provider availability.

  

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