000			03844cam a2200229 4500
001			NMDX6632
008			120401t2004 xxu||||| |||| 00| 0 eng d
022			_a10273719
100			_aPaynter, S.
240			_aInternational Journal of Tuberculosis and Lung Disease
245			_aPatient and health service delays in initiating treatment for patients with pulmonary tuberculosis: retrospectivecohort study
260			_c2004
500			_aNMUH Staff Publications
500			_a8
520			_a<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">SETTING:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">Catchment population of the North Middlesex University Hospital (NMUH), London, UK.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">OBJECTIVE:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">To measure patient and health care delays in treatment of pulmonary tuberculosis.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">DESIGN:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">Retrospective cohort study of patients notified with pulmonary tuberculosis between 1 April 2001 and 1 March 2002.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">The median case finding delays were between 78 and 99 days. Median patient-related delay was between 34.5 and 54 days. Median health care-related delay was 29.5 days. Shorter case finding delays were found in patients born in a high prevalence country, patients presenting first to Accident and Emergency department (A&E), younger patients, and those with sputum smear-positive disease. In those presenting first to A&E, those born in a high prevalence country, and those with sputum-positive disease, this effect was predominantly due to shorter health care delays. Limitations of TB service capacity and organisational factors appeared responsible for up to half of the difference in delay between those presenting to A&E or general practitioners (GPs).</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">CONCLUSION:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">Patient and health service delays contribute substantially to delays in patients accessing treatment. Considerable reduction in case finding delays may be achieved through changes in the capacity of tuberculosis services, and coordination of associated health services.</span></p>
700			_aHayward, A.
700			_aWilkinson, P.
700			_aLozewicz, S.
700			_aCoker, R.
856			_uwww.ncbi.nlm.nih.gov/pubmed/15139446
856			_uhttp://docstore.ingenta.com/cgi-bin/ds_deliver/1/u/d/ISIS/78547061.1/iuatld/ijtld/2004/00000008/00000002/art00004/100F0017EB894CD914041264842BC12A425A3C7066.pdf?link=http://www.ingentaconnect.com/error/delivery&format=pdf
999			_c75789 _d75789