title: A comparative study of tuberculosis patients initiated on ART and receiving different models of TB-HIV care.
abstract: METHODS
  Although health policy in South Africa calls for the integration of services, the effectiveness of different models of integration on patient outcomes has not been well demonstrated.
  
  
  OBJECTIVE
  To evaluate the outcomes of coinfected patients starting antiretroviral treatment (ART) in a tuberculosis (TB) hospital who received different models of ongoing care.
  
  
  METHODS
  This cohort study compared outcomes for 271 coinfected patients who started ART in a TB hospital in the Western Cape. After discharge, one group of patients received anti-tuberculosis treatment and ART from different providers, in the same or in different clinics (vertical care). The other group received anti-tuberculosis treatment and ART at the same visit from the same service provider (integrated care). Demographic and clinical data and TB and ART outcomes were compared.
  
  
  RESULTS
  The vertical care model had more unfavourable outcomes for anti-tuberculosis treatment (28.7% vs. 5.9%, P < 0.001) and ART (30.1% vs. 7.4%, P < 0.001) than the integrated care model. The vertical care model showed no difference whether services were provided by two service providers in the same or in geographically separate primary health care clinics.
  
  
  CONCLUSIONS
  Patient outcomes were better when TB and HIV care was received from the same service provider at the same visit.
authors.affiliation: Brewelskloof Hospital, Worcester, Western Cape, South Africa.
authors.forename: S A
authors.initials: SA
authors.lastname: Schulz
authors.forename: H R
authors.initials: HR
authors.lastname: Draper
authors.forename: P
authors.initials: P
authors.lastname: Naidoo
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D060085:Coinfection; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006763:Hospitals, Chronic Disease / Q000458:organization & administration*; D006801:Humans; D008297:Male; D011787:Quality of Health Care / Q000458:organization & administration; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents