The median healthcare delay for patients with tuberculosis (TB) in the United States is 24 days, according to a study published in The Lancet Infectious Diseases. Researchers conducted a retrospective, observational cohort study measuring US TB healthcare delays between 2008 and 2016 based on repurposed private insurance claims data. They confirmed 738 active TB cases, which had a median healthcare delay of 24 days (interquartile range, 10-45 days). Longer delays correlated with older age (8.4% longer delay per 10-year increase in age) and with non-HIV immunosuppression (19.2%) in a multivariable analysis. Relative to presenting with one symptom, presenting with three or more symptoms correlated with shorter delays (−22.5%). Shorter delays were also seen in association with the use of chest imaging, a TB nucleic acid amplification test, or care by a TB specialist provider (−24.9%, −19.2%, and −17.2%, respectively). Even after adjustment for patient characteristics and a higher rate of secondary TB among dependents, longer delays correlated with a higher rate of respiratory complications. “Our findings point to the key importance of continuing education of providers,” a coauthor said in a statement. “We found several factors associated with delays and faster diagnosis. This tells us that delays are modifiable and preventable.”
