PMID- 10587321
OWN - NLM
STAT- MEDLINE
DCOM- 19991221
LR  - 20220310
IS  - 1027-3719 (Print)
IS  - 1027-3719 (Linking)
VI  - 3
IP  - 11
DP  - 1999 Nov
TI  - Delay and discontinuity--a survey of TB patients' search of a diagnosis in a 
      diversified health care system.
PG  - 992-1000
AB  - SETTING: Ho Chi Minh City (HCMC), Vietnam. OBJECTIVES: To describe delay to 
      diagnosis; to compare diagnostic procedures and referral routines used by private 
      and public health care providers; and to examine associations between contact 
      with various types of providers and risk of delay to TB diagnosis. DESIGN: 
      Cross-sectional survey of new patients in the National Tuberculosis Programme 
      (NTP). Retrospective assessment of health seeking and diagnostic procedures used 
      by previously contacted health care providers. RESULTS: Four weeks after first 
      symptom, 81% of patients had sought help outside the household. Four weeks after 
      first health care contact, 47% had been diagnosed with TB. Private physicians 
      used X-rays, sputum smears, and referrals significantly less often than public 
      health care providers. Patients who had turned first to a private pharmacy, a 
      private physician or a public hospital were significantly more likely to have a 
      long provider delay than those who turned first to the NTP. CONCLUSION: Delay to 
      diagnosis of TB in HCMC is due more to inability among health care providers to 
      detect TB than to under-utilisation of health care services. Diagnostic 
      procedures need to be improved and referral chains need to be strengthened in 
      HCMC, particularly among private providers.
FAU - Lonnroth, K
AU  - Lonnroth K
AD  - Department of Social Medicine, Goteborg University, Sweden. 
      knut.lonnroth@socmed.gu.se
FAU - Thuong, L M
AU  - Thuong LM
FAU - Linh, P D
AU  - Linh PD
FAU - Diwan, V K
AU  - Diwan VK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - France
TA  - Int J Tuberc Lung Dis
JT  - The international journal of tuberculosis and lung disease : the official journal 
      of the International Union against Tuberculosis and Lung Disease
JID - 9706389
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Continuity of Patient Care
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Private Sector
MH  - Referral and Consultation
MH  - Time Factors
MH  - Tuberculosis, Pulmonary/*diagnosis
MH  - Vietnam
EDAT- 1999/12/10 00:00
MHDA- 1999/12/10 00:01
CRDT- 1999/12/10 00:00
PHST- 1999/12/10 00:00 [pubmed]
PHST- 1999/12/10 00:01 [medline]
PHST- 1999/12/10 00:00 [entrez]
PST - ppublish
SO  - Int J Tuberc Lung Dis. 1999 Nov;3(11):992-1000.