Effect of a publicly funded tuberculosis service on the diagnosis of tuberculosis at a teaching hospital.
The speed and accuracy of diagnosis of tuberculosis on general medical teaching services were retrospectively compared to that on a designated publicly funded tuberculosis service and to recent discouraging reports in the literature. The diagnosis was confirmed in all patients on the designated service and in 78.8% of patients not on the designated service within one week. No patient was discharged undiagnosed. Acid-fast smears done by the hospital laboratory showed a sensitivity of 82.5% and a specificity of 98.4%. Radiologic reports indicated the presence of tuberculosis or cavities in 85% of chest x-ray films in patients with pulmonary disease. These results may indicate that a publicly funded tuberculosis service, by providing emphasis on tuberculosis, allows more rapid and accurate diagnosis of tuberculosis in all patients. The impact of such training on future health care delivery should be recognized when decisions regarding allocation of public funds are made.
D000407:Alabama; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D005380:Financing, Government; D006745:Hospital Bed Capacity, 300 to 499; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007388:Internal Medicine / Q000193:education; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010043:Outcome and Process Assessment, Health Care; D011635:Public Health Administration; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000000981:diagnostic imaging; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*