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Mind the gap! Risk factors for poor continuity of care of TB patients discharged from a hospital in the Western Cape, South Africa

dc.contributor.authorDudley, Lilianen_ZA
dc.contributor.authorMukinda, Fideleen_ZA
dc.contributor.authorDyers, Robinen_ZA
dc.contributor.authorMarais, Fredericken_ZA
dc.contributor.authorSissolak, Dagmaren_ZA
dc.date.accessioned2020-05-21T19:51:41Z
dc.date.available2020-05-21T19:51:41Z
dc.date.issued2018
dc.identifier.citationDudley, L., et al. 2018. Mind the gap! Risk factors for poor continuity of care of TB patients discharged from a hospital in the Western Cape, South Africa. PLoS ONE, 13(1):e0190258, doi:10.1371/journal.pone.0190258.
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0190258.
dc.identifier.urihttp://hdl.handle.net/10019.1/108586
dc.descriptionCITATION: Dudley, L., et al. 2018. Mind the gap! Risk factors for poor continuity of care of TB patients discharged from a hospital in the Western Cape, South Africa. PLoS ONE, 13(1):e0190258, doi:10.1371/journal.pone.0190258.
dc.descriptionThe original publication is available at https://journals.plos.org/plosone/
dc.description.abstractBackground: TB patients discharged from hospitals in South Africa experience poor continuity of care, failing to continue TB treatment at other levels of care. Factors contributing to poor continuity of TB care are insufficiently described to inform interventions. Objective: To describe continuity of care and risk factors in TB patients discharged from a referral hospital in the Western Cape, South Africa. Design: This retrospective observational study used routine information to describe continuity of care and risk factors in TB patients discharged from hospital. Results: 788 hospitalized TB patients were identified in 6 months. Their median age was 32 years, 400 (51%) were male, and 653 (83%) were urban. A bacteriological TB test was performed for 74%, 25% were tested for HIV in hospital, and 32% of all TB patients had documented evidence of HIV co-infection. Few (13%) were notified for TB; 375 (48%) received TB medication; 284 (36%) continued TB treatment after discharge; 91 (24%) had a successful TB treatment outcome, and 166 (21%) died. Better continuity of care was associated with adults, urban residence, bacteriological TB tests in hospital and TB medication on discharge. Fragmented hospital TB data systems did not provide continuity with primary health care information systems. Conclusions: Discharged TB patients experienced poor continuity of care, with children, rural patients, those not tested for TB in hospital or discharged without TB medication at greatest risk. Suboptimal quality of hospital TB care and a fragmented hospital information system without linkages to other levels underpinned poor continuity of care.en_ZA
dc.description.urihttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190258
dc.format.extent11 pages
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science
dc.subjectTB patientsen_ZA
dc.titleMind the gap! Risk factors for poor continuity of care of TB patients discharged from a hospital in the Western Cape, South Africaen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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