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Free Content Ensuring accountability: the contribution of the cohort review method to tuberculosis control in New York City

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SETTING: In 1993, the New York City (NYC) Bureau of Tuberculosis Control developed the cohort review process as a quality assurance method to track and improve patient outcomes.

METHODS: The Bureau Director reviews every tuberculosis (TB) case quarterly in a multi-disciplinary staff meeting. In 2004 we also began collecting details on issues identified at cohort review to quantify how this process directly impacts TB control efforts.

RESULTS: From 1992 to 2004, NYC TB cases decreased by 72.7% and treatment success rates significantly increased by 26.7%. Implementing the cohort review was key to improving case management, thus leading to these results. For the 1039 patients in 2004, 596 issues were identified among 424 patients; 55.0% were incorrect, unclear or unknown patient information, 13.8% were treatment issues, 12.4% were case management issues and 10.6% were incomplete contact investigations. Most (76.5%) issues were addressed within 30 days of the cohort reviews.

CONCLUSION: A systematic review of every TB case improves the quality of patient information, enhances patient treatment and ensures accountability at all levels of the TB control program.
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Keywords: patient management; program evaluation; treatment success; tuberculosis

Document Type: Regular Paper

Affiliations: 1: New York City Department of Health and Mental Hygiene, New York, New York, USA; and Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: New York City Department of Health and Mental Hygiene, New York, New York, USA 3: Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and The International Union Against Tuberculosis and Lung Disease, Paris, France

Publication date: 2006-10-01

More about this publication?
  • 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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