title: Seasonal variation and hospital utilization for tuberculosis in Russia: hospitals as social care institutions.
abstract: BACKGROUND
  Clinical management of tuberculosis in Russia involves lengthy hospitalizations, in contrast to the recommended strategy advocated by the World Health Organization.
  
  
  METHODS
  We used Fourier transform, spectral analysis and Student's t-test to analyse periodic and seasonal variations in admission and discharge rates for tuberculosis hospitalizations in 1999-2002, using routinely captured data from the Samara Region, Russia.
  
  
  RESULTS
  Hospital admissions in colder months were significantly higher than in warmer months. The mean monthly adjusted number of admissions in colder and warmer months for all adults was 413 and 372 (P < 0.01), for unemployed adults 218 and 198 (P < 0.02) and for pensioners 104 and 82 (P < 0.05). Hospital discharges varied seasonally. Maximum differences between admissions and discharges occurred in colder months and minimum differences were observed in warmer months.
  
  
  CONCLUSIONS
  As hospitalizations of tuberculosis patients in colder months fulfil an important social need, shifts to ambulatory care must be carefully managed.
authors: Health Centre for Health Management, Tanaka Business School, Imperial College London, South Kensington Campus, London, UK. r.atun@imperial.ac.uk
authors: R A
authors: RA
authors: Atun
authors: Y A
authors: YA
authors: Samyshkin
authors: F
authors: F
authors: Drobniewski
authors: S I
authors: SI
authors: Kuznetsov
authors: I M
authors: IM
authors: Fedorin
authors: R J
authors: RJ
authors: Coker
mesh_terms: D000293:Adolescent; D000328:Adult; D003080:Cold Temperature; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012426:Russia / Q000453:epidemiology; D012621:Seasons; D012946:Social Welfare / Q000639:trends*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000628:therapy*