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Distinct healthcare utilization profiles of high healthcare use tuberculosis survivors: A latent class analysis

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  • Kamila Romanowski
  • Mohammad Ehsanul Karim
  • Mark Gilbert
  • Victoria J Cook
  • James C Johnston

Abstract

Background: Recent data have demonstrated that healthcare use after treatment for respiratory tuberculosis (TB) remains elevated in the years following treatment completion. However, it remains unclear which TB survivors are high healthcare users and whether any variation exists within this population. Thus, the primary objective of this study was to identify distinct profiles of high healthcare-use TB survivors to help inform post-treatment support and care. Methods: Using linked health administrative data from British Columbia, Canada, we identified foreign-born individuals who completed treatment for incident respiratory TB between 1990 and 2019. We defined high healthcare-use TB survivors as those in the top 10% of annual emergency department visits, hospital admissions, or general practitioner visits among the study population during the five-year period immediately following TB treatment completion. We then used latent class analysis to categorize the identified high healthcare-use TB survivors into subgroups. Results: Of the 1,240 people who completed treatment for respiratory TB, 258 (20.8%) people were identified as high post- TB healthcare users. Latent class analysis results in a 2-class solution. Class 1 (n = 196; 76.0%) included older individuals (median age 71.0; IQR 59.8, 79.0) with a higher probability of pre-existing hypertension and diabetes (41.3% and 33.2%, respectively). Class 2 (n = 62; 24.0%) comprised of younger individuals (median age 31.0; IQR 27.0, 41.0) with a high probability (61.3%) of immigrating to Canada within five years of their TB diagnosis and a low probability (11.3%) of moderate to high continuity of primary care. Discussion: Our findings suggest that foreign-born high healthcare-use TB survivors in a high-resource setting may be categorized into distinct profiles to help guide the development of person-centred care strategies targeting the long-term health impacts TB survivors face.

Suggested Citation

  • Kamila Romanowski & Mohammad Ehsanul Karim & Mark Gilbert & Victoria J Cook & James C Johnston, 2023. "Distinct healthcare utilization profiles of high healthcare use tuberculosis survivors: A latent class analysis," PLOS ONE, Public Library of Science, vol. 18(9), pages 1-15, September.
    • Handle: RePEc:plo:pone00:0291997
    DOI: 10.1371/journal.pone.0291997
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    References listed on IDEAS

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    1. Linzer, Drew A. & Lewis, Jeffrey B., 2011. "poLCA: An R Package for Polytomous Variable Latent Class Analysis," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i10).
    2. Deborah Peikes & Arnold Chen & Jennifer Schore & Randall Brown, 2009. "Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare Beneficiaries: 15 Randomized Trials," Mathematica Policy Research Reports ce70f11be1b44e2c8590b9cf5, Mathematica Policy Research.
    3. repec:mpr:mprres:6184 is not listed on IDEAS
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