title: Social factors influencing hospital utilisation by tuberculosis patients in the Russian Federation: analysis of routinely collected data.
abstract: OBJECTIVE
  To establish whether admissions, discharges and hospital utilisation for tuberculosis (TB) in Russia are independent of sex, age, disability and employment status.
  
  
  METHODS
  Analysis of hospital admissions, discharges and in-patient utilisation using routinely collected data in Samara Region of the Russian Federation.
  
  
  RESULTS
  Male, unemployed and disabled adults were significantly more likely to be hospitalised (P < 0.001). The unemployed and pensioners were more likely to have multiple admissions. Unemployed adults were more likely to have longer average lengths of stay per admission (P < 0.001), with a cumulative length of stay for unemployed and disabled adults significantly greater than for employed adults and adults with no disability. Interruption of hospital care was significantly more frequent in male, disabled and unemployed patients (P < 0.001).
  
  
  CONCLUSIONS
  Socio-economic factors influence hospital admission patterns and the length of stay for patients when hospitalised, as the providers of TB services attempt to mitigate the lack of social care provision for patients. For the WHO DOTS strategy to be effectively implemented and sustained in the Russian Federation health system, social sector linkage issues need to be addressed.
authors.affiliation: Centre for Health Management, Tanaka Business School, Imperial College London, South Kensington Campus, London, UK. r.atun@imperial.ac.uk
authors.forename: R A
authors.initials: RA
authors.lastname: Atun
authors.forename: Y A
authors.initials: YA
authors.lastname: Samyshkin
authors.forename: F
authors.initials: F
authors.lastname: Drobniewski
authors.forename: S I
authors.initials: SI
authors.lastname: Kuznetsov
authors.forename: I M
authors.initials: IM
authors.lastname: Fedorin
authors.forename: R J
authors.initials: RJ
authors.lastname: Coker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D014478:Unemployment / Q000706:statistics & numerical data