BACKGROUND: Managing tuberculosis in foreign born patients entails a complex interaction between patient and provider. METHODS: Using a retrospective cohort study and survival analysis, this study evaluates the impact of patient and provider factors on the survival of foreign born outpatients with active tuberculosis. The primary outcome of the study is 1 year all-cause mortality. RESULTS: In our cohort, patient-provider language discordance was associated with an increased risk of death [HR: 2.33; 95% CI: 1.39-3.88], while receiving treatment from a tuberculosis experienced physician [HR: 0.41; 95% CI: 0.22-0.77] and treatment in a dedicated tuberculosis clinic [HR: 0.53; 95% CI: 0.29-0.98] was associated with a lower risk of death. DISCUSSION: Patient-provider communication and health systems factors played a large role in the survival of our cohort of foreign born tuberculosis outpatients. These findings suggest that language barriers and the provision of care by experienced providers in specialized clinic settings may have important effects on health outcomes.
BACKGROUND: Managing tuberculosis in foreign bornpatients entails a complex interaction between patient and provider. METHODS: Using a retrospective cohort study and survival analysis, this study evaluates the impact of patient and provider factors on the survival of foreign born outpatients with active tuberculosis. The primary outcome of the study is 1 year all-cause mortality. RESULTS: In our cohort, patient-provider language discordance was associated with an increased risk of death [HR: 2.33; 95% CI: 1.39-3.88], while receiving treatment from a tuberculosis experienced physician [HR: 0.41; 95% CI: 0.22-0.77] and treatment in a dedicated tuberculosis clinic [HR: 0.53; 95% CI: 0.29-0.98] was associated with a lower risk of death. DISCUSSION: Patient-provider communication and health systems factors played a large role in the survival of our cohort of foreign born tuberculosis outpatients. These findings suggest that language barriers and the provision of care by experienced providers in specialized clinic settings may have important effects on health outcomes.
Authors: Ava John-Baptiste; Gary Naglie; George Tomlinson; Shabbir M H Alibhai; Edward Etchells; Angela Cheung; Moira Kapral; Wayne L Gold; Howard Abrams; Maria Bacchus; Murray Krahn Journal: J Gen Intern Med Date: 2004-03 Impact factor: 5.128
Authors: Jennifer L Barton; John Imboden; Jonathan Graf; David Glidden; Edward H Yelin; Dean Schillinger Journal: Arthritis Care Res (Hoboken) Date: 2010-06 Impact factor: 4.794
Authors: Michael Reaume; Ricardo Batista; Robert Talarico; Emily Rhodes; Eva Guerin; Sarah Carson; Denis Prud'homme; Peter Tanuseputro Journal: BMC Health Serv Res Date: 2020-04-21 Impact factor: 2.655
Authors: Helen R Stagg; Ibrahim Abubakar; James Brown; Maeve K Lalor; H Lucy Thomas; Tehreem Mohiyuddin; Debora Pedrazzoli; Corinne S Merle Journal: BMC Med Date: 2016-03-23 Impact factor: 8.775