1. Impact of port of entry referrals on initiation of follow-up evaluations for immigrants with suspected tuberculosis: Illinois.
- Author
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Bell TR, Molinari NM, Blumensaadt S, Selent MU, Arbisi M, Shah N, Christiansen D, Philen R, Puesta B, Jones J, Lee D, Vang A, and Cohen NJ
- Subjects
- Adult, Centers for Disease Control and Prevention, U.S., Female, Follow-Up Studies, Humans, Illinois, Male, Middle Aged, Survival Analysis, Time Factors, United States, Young Adult, Emigrants and Immigrants statistics & numerical data, Mass Screening standards, Referral and Consultation statistics & numerical data, Tuberculosis diagnosis, Tuberculosis ethnology
- Abstract
US-bound immigrants with suspected non-infectious TB are encouraged to be medically re-evaluated after arrival in the United States. We evaluated the Centers for Disease Control and Prevention's immigrant referral process, designed to facilitate timely post-arrival evaluations. Over 1,200 immigrants with suspected TB arriving during October 1, 2008-September 30, 2010 were identified. In 2011, differences in days to evaluation initiation were assessed by referral type using survival analysis and Cox proportional hazard models. Among those receiving any referral, median time to post-arrival evaluation was significantly lower compared with immigrants receiving no referral (16 vs. 69 days, respectively; p < 0.0001). After adjusting for the covariates, immigrants receiving any referral initiated follow-up at 4 times the rate (adjusted hazard ratio = 4.0; p < 0.0001) of those receiving no referral. Implementing a referral system at US ports of entry will improve timeliness and increase the proportion of immigrants initiating domestic evaluation.
- Published
- 2013
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