Table 1.
Comparison of care quality at different levels of institutions
| Medical center (n = 112) | Regional hospital (n = 155) | District hospital/primary practitioners (n = 100) | Chest specialty hospital (n = 54) | P-value | |
| Diagnostic physiciana; n (%) | < 0.001 | ||||
| Pulmonologist | 76 (67.9) | 118 (76.1) | 67 (67.0) | 53 (98.1) | |
| Non-pulmonologist | 36(32.1) | 37 (23.9) | 33 (33.0) | 1 (1.9) | |
| Quality of diagnosis; n (%) | |||||
| Sputum specimens for diagnosisa | < 0.001 | ||||
| <3 specimens | 58(51.8) | 98 (63.2) | 50 (50.0) | 14 (25.9) | |
| ≥ 3 specimens | 54 (48.2) | 57 (36.8) | 50 (50.0) | 40(74.1) | |
| Positive sputum smear but negative sputum culture resultsa | < 0.001 | ||||
| Yes | 1 (0.9) | 12 (7.7) | 19 (19.0) | 2 (3.7) | |
| No | 111 (99.1) | 143 (92.3) | 81 (81.0) | 52 (96.3) | |
| Timeliness (mean ± SD) | |||||
| Days between chest X-ray examination and the hospital visitb (n = 415) | 1.8 ± 6.0 | 1.8 ± 5.6 | 1.7 ± 3.4 | 1.0 ± 0.0 | 0.044 |
| Days between the sputum examination and the hospital visitb (n = 415) | 4.9 ± 13.3 | 4.1 ± 8.2 | 4.8 ± 14.7 | 1.5 ± 2.9 | < 0.001 |
| Healthcare institution delay1,b (n = 378) | 31.0 ± 53.6 | 31.2 ± 70.4 | 25.4 ± 3 7.6 | 10.1 ± 18.3 | < 0.001 |
| Positive AFB smearb (n = 235) | 11.2 ± 16.2 | 13.4 ± 31.4 | 15.7 ± 30.6 | 4.7 ± 7.1 | 0.003 |
| Negative AFB smearb (n = 143) | 69.9 ± 76.2 | 53.3 ± 95.5 | 44.3 ± 42.8 | 20.1 ± 27.0 | 0.001 |
| Laboratory diagnostic delay2,b (n = 415) | 2.6 ± 2.1 | 4.5 ± 3.1 | 3.5 ± 2.6 | 2.4 ± 2.4 | < 0.001 |
| Outcome; n (%) | |||||
| Successful treatmenta (n= 421) | 0.001 | ||||
| Yes | 73 (65.2) | 99 (63.9) | 68 (68.0) | 50 (92.6) | |
| No | 39 (34.8) | 56(36.1) | 32 (32.0) | 4 (7.4) | |
| Fatalitya (n = 421) | 0.002 | ||||
| Yes | 31 (27.7) | 50 (32.3) | 28 (28.0) | 3 (5.6) | |
| No | 81 (72.3) | 105 (67.7) | 72 (72.0) | 51 (94.4) |
AFB, acid-fast bacilli
aUsing the chi-square test
bUsing the Kruskal Wallis test
1Healthcare institution delay indicates days between the first related hospital visit and the initiation of anti-TB medication
2Laboratory diagnostic delay indicates workdays for reporting sputum smear examination results at the hospital