title: Patient and health care system delays in Queensland tuberculosis patients, 1985-1998.
abstract: METHODS
  Queensland tuberculosis (TB) control centre QTCC).
  
  
  OBJECTIVE
  To investigate patient and health care system delays in the diagnosis of active TB in Queensland.
  
  
  METHODS
  Analysis of data extracted from the QTCC database and review of charts. Symptomatic patients with bacteriologically or histologically proven TB were considered as a total group and a pulmonary smear-positive (PSP) group.
  
  
  RESULTS
  The median patient delays were 29 days (total group) and 30 days (PSP group). The median health care system delays were 22 days (total group) and 11 days (PSP group). There were significant trends towards increasing health care system delays with increasing age and longer residency of migrants in Australia. Health care system delays were significantly longer for females and those aged over 45. Migrants from countries of high TB incidence and indigenous Australians had shorter health care system delays compared to non-indigenous Australians. Common reasons for diagnostic delays of more than 90 days were failure to perform appropriate investigations and misdiagnosis of chest X-rays.
  
  
  CONCLUSIONS
  Physicians need to consider including TB in the differential diagnosis in older age groups and migrants with longer residency in Australia. There should be a low threshold for obtaining chest X-rays and sputum samples in patients with persistent cough.
authors.affiliation: Specialised Health Services (Queensland Tuberculosis Control Centre), Coorparoo DC, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Ward
authors.forename: V
authors.initials: V
authors.lastname: Siskind
authors.forename: A
authors.initials: A
authors.lastname: Konstantinos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology / Q000208:ethnology; D003937:Diagnosis, Differential; D004641:Emigration and Immigration; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy