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Hospital admission policy for tuberculosis in pulmonary centres in Italy: a national survey

Authors: Nutini, S.1; Fiorentini, F.2; Codecasa, L. R.3; Casali, L.4; Besozzi, G.3; Di Pisa, G.5; Nardini, S.6; Migliori, G. B.7; AIPO Tuberculosis Study Group2

Source: The International Journal of Tuberculosis and Lung Disease, Volume 3, Number 11, November 1999 , pp. 985-991(7)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: A national survey including 203 pulmonary centres (PCs) (144 hospital PCs with beds dedicated to TB patients and 59 out-patient PCs) managing tuberculosis cases in Italy during 1995.

OBJECTIVES: To evaluate: 1) hospitalisation practices (criteria for admission/discharge; duration of hospitalisation) as primary end-points; and 2) as secondary end-points the availability of beds, the preventive measures adopted to reduce the spread of infection, the sources of referral for hospitalisation and the procedures adopted to follow up TB patients after discharge.

DESIGN: A 26-point questionnaire mailed to 203 PCs.

RESULTS: Of 167 PCs that responded to the questionnaire (82.3%), 159 questionnaires were considered valid for the analysis (110 from hospitals PCs and 49 from out-patient PCs). The criteria adopted by PCs to admit TB patients were: all TB cases 47%, only smear-positive pulmonary TB 14%, TB cases with clinical problems 39%. Hospital PCs hospitalised significantly more cases of smear-negative, extra-pulmonary TB. On average 71.6% of all cases were hospitalised (88.2% by hospital and 28% by out-patient PCs). The median hospital stay was 34 days for sputum smear-positive, 20 for sputum smear-negative and 21.5 for extra-pulmonary TB cases. Sputum conversion was considered the mandatory criterion to allow discharge from 61% of hospital PCs.

CONCLUSION: A switch from the present policy (majority of cases hospitalised for a long period) to an out-patient oriented policy needs the co-ordinated educational effort of scientific societies and health authorities.

Keywords: hospital admission policy; treatment; tuberculosis

Document Type: Regular Paper

Affiliations: 1: U.O. Pneumologia II, Azienda Ospedaliera Careggi, Firenze, Italy 2: Ospedale Vecchiazzano, Forlì, Italy 3: Istituto Villa Marelli, Milano, Italy 4: Università di Perugia, Italy 5: Ospedale di Bormio e Sondalo, Italy 6: Ospedale di Vittorio Veneto, Italy 7: Fondazione Salvatore Maugeri, Care and Research Institute, Tradate, Italy

Publication date: November 1, 1999

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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