Vulnerability Assessment and Enhanced Community-based Care and Management of Patients With Tuberculosis in Korea: A Crossover Design
- Author:
Jeongmi SEO
1
;
Dawoon JEONG
;
In-Hyuk LEE
;
Jiyeon HAN
;
Yunhyung KWON
;
Eunhye SHIM
;
Hongjo CHOI
Author Information
- Publication Type:Original Article
- From:Journal of Preventive Medicine and Public Health 2025;58(3):317-325
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:People-centered care and social protection are critical for improving tuberculosis (TB) treatment outcomes. This study aimed to evaluate whether a vulnerability assessment tool, developed for an enhanced community-based care and management (ECCM) program in 2 Korean cities, could predict and improve final TB treatment outcomes based on patients’ vulnerability levels.
Methods:Treatment outcomes in the ECCM group were compared with those in a control group, stratified by vulnerability level. During stage 1, one city served as the intervention region and the other as the control, with a crossover in stage 2. The vulnerability assessment included all notified patients with TB, and those identified as highly vulnerable in the intervention group received social support following a consultation with a case manager.
Results:The vulnerability assessment tool demonstrated moderate predictive ability for unfavorable outcomes, with an area under the curve of 0.70 (95% confidence interval, 0.63 to 0.77). The patients with high vulnerability who received ECCM treatment demonstrated a 19.8-percentage point (%p) higher treatment success rate than the high vulnerability subcategory of the control group. ECCM also appeared to reduce loss to follow-up and TB-related mortality by 8.4%p and 7.3%p, respectively, although these findings should be interpreted with caution.
Conclusions:The results suggest that providing social support tailored to patient vulnerability at the time of diagnosis could improve TB treatment outcomes.
