Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea
Abstract In South Korea, public–private mix (PPM) was launched in 2011. This retrospective cohort study sought to determine the rate of loss to follow-up (LTFU) among drug-susceptible tuberculosis (DS-TB) patients in all nationwide PPM institutions, and the risk factors for LTFU. National notificati...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-16441-7 |
| _version_ | 1827984787677118464 |
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| author | Hyung Woo Kim Sohee Park Jinsoo Min Jiyu Sun Ah Young Shin Jick Hwan Ha Jae Seuk Park Sung-Soon Lee Marc Lipman Ibrahim Abubakar Helen R. Stagg Ju Sang Kim |
| author_facet | Hyung Woo Kim Sohee Park Jinsoo Min Jiyu Sun Ah Young Shin Jick Hwan Ha Jae Seuk Park Sung-Soon Lee Marc Lipman Ibrahim Abubakar Helen R. Stagg Ju Sang Kim |
| author_sort | Hyung Woo Kim |
| collection | DOAJ |
| description | Abstract In South Korea, public–private mix (PPM) was launched in 2011. This retrospective cohort study sought to determine the rate of loss to follow-up (LTFU) among drug-susceptible tuberculosis (DS-TB) patients in all nationwide PPM institutions, and the risk factors for LTFU. National notification data for DS-TB patients diagnosed between August 2011 and July 2014 in PPM institutions were analysed. Determination of LTFU included detection of instances where patients were transferred out, but when they did not attend at other TB centres in the following two months. Univariable and multivariable competing risk models were used to determine risk factors for LTFU. 73,046 patients with 78,485 records were enrolled. Nominally, 3426 (4.4%) of records were LTFU. However, after linking the multiple records in each patient, the percentage of LTFU was 12.3% (9004/73,046). Risk factors for LTFU were: being foreign-born (3.13 (95% CI 2.77–3.53)), prior LTFU (2.31 (2.06–2.59)) and greater distance between the patient’s home and the TB centre (4.27 (4.03–4.53)). ‘Transfer-out’ was a risk factor in patients managed by treatment centres close to home (1.65 (1.49–1.83)), but protective for those attending centres further (0.77 (0.66–0.89)) or far-away (0.52 (0.46–0.59)) from home. By considering the complete picture of a patient’s interactions with healthcare, we identified a much higher level of LTFU than previously documented. This has implications for how outcomes of treatment are reported and argues for a joined-up national approach for the management and surveillance of TB patients, in nations with similar healthcare systems. |
| first_indexed | 2024-04-09T23:03:12Z |
| format | Article |
| id | doaj.art-b584cf5d834c4b9ca181bf252386c5eb |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T23:03:12Z |
| publishDate | 2022-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-b584cf5d834c4b9ca181bf252386c5eb2023-03-22T10:50:40ZengNature PortfolioScientific Reports2045-23222022-07-0112111110.1038/s41598-022-16441-7Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South KoreaHyung Woo Kim0Sohee Park1Jinsoo Min2Jiyu Sun3Ah Young Shin4Jick Hwan Ha5Jae Seuk Park6Sung-Soon Lee7Marc Lipman8Ibrahim Abubakar9Helen R. Stagg10Ju Sang Kim11Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaInstitute of Health Services Research, Yonsei UniversityDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of MedicineUCL-TB, University College LondonInstitute for Global Health, University College LondonUsher Institute, The University of EdinburghDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract In South Korea, public–private mix (PPM) was launched in 2011. This retrospective cohort study sought to determine the rate of loss to follow-up (LTFU) among drug-susceptible tuberculosis (DS-TB) patients in all nationwide PPM institutions, and the risk factors for LTFU. National notification data for DS-TB patients diagnosed between August 2011 and July 2014 in PPM institutions were analysed. Determination of LTFU included detection of instances where patients were transferred out, but when they did not attend at other TB centres in the following two months. Univariable and multivariable competing risk models were used to determine risk factors for LTFU. 73,046 patients with 78,485 records were enrolled. Nominally, 3426 (4.4%) of records were LTFU. However, after linking the multiple records in each patient, the percentage of LTFU was 12.3% (9004/73,046). Risk factors for LTFU were: being foreign-born (3.13 (95% CI 2.77–3.53)), prior LTFU (2.31 (2.06–2.59)) and greater distance between the patient’s home and the TB centre (4.27 (4.03–4.53)). ‘Transfer-out’ was a risk factor in patients managed by treatment centres close to home (1.65 (1.49–1.83)), but protective for those attending centres further (0.77 (0.66–0.89)) or far-away (0.52 (0.46–0.59)) from home. By considering the complete picture of a patient’s interactions with healthcare, we identified a much higher level of LTFU than previously documented. This has implications for how outcomes of treatment are reported and argues for a joined-up national approach for the management and surveillance of TB patients, in nations with similar healthcare systems.https://doi.org/10.1038/s41598-022-16441-7 |
| spellingShingle | Hyung Woo Kim Sohee Park Jinsoo Min Jiyu Sun Ah Young Shin Jick Hwan Ha Jae Seuk Park Sung-Soon Lee Marc Lipman Ibrahim Abubakar Helen R. Stagg Ju Sang Kim Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea Scientific Reports |
| title | Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea |
| title_full | Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea |
| title_fullStr | Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea |
| title_full_unstemmed | Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea |
| title_short | Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea |
| title_sort | hidden loss to follow up among tuberculosis patients managed by public private mix institutions in south korea |
| url | https://doi.org/10.1038/s41598-022-16441-7 |
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