Vulnerability Assessment and Enhanced Community-based Care and Management of Patients With Tuberculosis in Korea: A Crossover Design

Objectives: People-centered care and social protection are critical for improving tuberculosis (TB) treatment outcomes. This study aimed to evaluate whether a vulnerability assessment tool, developed for an enhanced community-based care and management (ECCM) program in 2 Korean cities, could predict...

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Vydáno v:Journal of preventive medicine and public health Ročník 58; číslo 3; s. 317 - 325
Hlavní autoři: Seo, Jeongmi, Jeong, Dawoon, Lee, In-Hyuk, Han, Jiyeon, Kwon, Yunhyung, Shim, Eunhye, Choi, Hongjo
Médium: Journal Article
Jazyk:angličtina
Vydáno: Korea (South) Korean Society for Preventive Medicine 01.05.2025
대한예방의학회
Témata:
Adult
Aged
case management
Community Health Services
Cross-Over Studies
Female
Humans
Male
Middle Aged
Original
Republic of Korea
Social Support
social vulnerability
Treatment Outcome
tuberculosis
Tuberculosis - drug therapy
Tuberculosis - therapy
vulnerable population
Vulnerable Populations
예방의학
Republic of Korea
Tuberculosis
Social vulnerability
Case management
Vulnerable population
ISSN:1975-8375, 2233-4521
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Popis
Shrnutí:Objectives: People-centered care and social protection are critical for improving tuberculosis (TB) treatment outcomes. This study aimed to evaluate whether a vulnerability assessment tool, developed for an enhanced community-based care and management (ECCM) program in 2 Korean cities, could predict and improve final TB treatment outcomes based on patients’ vulnerability levels.Methods: Treatment outcomes in the ECCM group were compared with those in a control group, stratified by vulnerability level. During stage 1, one city served as the intervention region and the other as the control, with a crossover in stage 2. The vulnerability assessment included all notified patients with TB, and those identified as highly vulnerable in the intervention group received social support following a consultation with a case manager.Results: The vulnerability assessment tool demonstrated moderate predictive ability for unfavorable outcomes, with an area under the curve of 0.70 (95% confidence interval, 0.63 to 0.77). The patients with high vulnerability who received ECCM treatment demonstrated a 19.8-percentage point (%p) higher treatment success rate than the high vulnerability subcategory of the control group. ECCM also appeared to reduce loss to follow-up and TB-related mortality by 8.4%p and 7.3%p, respectively, although these findings should be interpreted with caution.Conclusions: The results suggest that providing social support tailored to patient vulnerability at the time of diagnosis could improve TB treatment outcomes.
ISSN:1975-8375
2233-4521
DOI:10.3961/jpmph.24.597