||Diez E, Claveria J, Serra T, Cayla JA, Jansa JM, Pedro
R & Villalbi JR
||Evaluation of a social health intervention among homeless
||TUBERCLE & LUNG DIS 1996, 77, 420-24
The setting is Homeless and other fringe groups
are a priority in the global strategies of TB prevention and control
in big cities, as a consequence of their generally poor adherence
to treatment and concurrent multiple social and health problems.
The objective is to evaluate a social care and health follow-up
programme targeting homeless TB patients in Ciutat Vella District,
Barcelona, which covered 210 patients from 1987 to 1992. During
directly observed treatment, primary health care and, if necessary,
accommodation was provided. The design of the study is the differential
TB incidence rate between Ciutat Vella and the other districts of
Barcelona, the percentage of successfully completed treatments and
the days of hospitalization saved by the programme were measured.
There was a significant decrease in the TB incidence
rate among homeless patients in Ciutat Vella (from 32.4 per 105
inhabitants in 1987, to 19.8 per 105 in 1992, P=0.03), compared
to an unchanged rate elsewhere (1.6 per 105 inhabitants in 1987,
compared to 1.7 per 105 in 1992, P=0.34). A smaller than expected
proportion, 19.6%, of patients failed to complete their treatment,
and a decrease in the mean period of hospitalization for TB in the
district hospital was recorded, falling from a mean 27.1 days in
1986 to a mean 15.7 days in 1992. The programme appears to be both
effective and efficient, as it has enabled a large number of homeless
patients to complete their treatment successfully, at the same time
saving twice the amount of funds invested.
|KEY WORDS: HEALTH POLICY; SOCIAL ASPECTS; HOMELESS
TB PATIENTS; BARCELONA.
Interaction with TB patients