Do patients with tuberculosis referred from a tertiary care referral centre reach their peripheral health institution.

ABSTRACT

Background. Tuberculosis (TB) is a major public health problem in India. The Revised National Tuberculosis Control Programme (RNTCP), started in 1997, involved medical colleges in the control of TB on a high priority. We assessed whether patients with TB referred from a tertiary care hospital in Delhi reached the desired peripheral health institution and had their treatment initiated. Methods. This descriptive, retrospective study was done at a tertiary care hospital and included all patients with a diagnosis of TB (pulmonary or extrapulmonary) who were seen at the referral centre during the year 2011. Data were collected from various records of the referral centre and analysed for availability of feedback of the referred patients. Information regarding their registration and initiation of treatment was also collected. Postcards were used for the first time to trace referrals in patients with TB. Results. The majority (94%) of patients with TB seen in the referral centre at a tertiary care facility were referred to a peripheral health institution nearest to their place of residence. Feedback on referral was received from these institutions for 79.4% of patients from the National Capital Region (NCR) of Delhi and for 47.4% of patients from outside the NCR of Delhi. Conclusion. We found that a majority of patients with TB were referred and the registration and initiation of treatment could be traced in >75% of patients.