Frequent visits to health care facilities is a common phenomenon in Taiwan, but one recent study suggested that it might increase the risk of tuberculosis due to nosocomial transmission of the disease.
The study was jointly led by Dr. Sung-Ching Pan from the National Taiwan University (NTU) Hospital and Dr. Chien-Chou Chen from NTU College of Public Health. Using a case–control study nested within the cohort of 1 million individuals, they analyzed the health insurance claims data and tracked the pre-morbid health seeking behavior of tuberculosis patients. Frequency of health care visits was associated with increased risk of tuberculosis in a dose-dependent manner after adjustment for other medical comorbidities and potential confounders. Compared with individuals with fewer than 5 visits per year, those with more than 30 had a 77% increase in tuberculosis risk. Furthermore, individuals who went to the same outpatient service as undiagnosed tuberculosis cases on the same day during the potentially infectious period had a significantly higher risk of developing tuberculosis subsequently. These findings were published in the July issue of American Journal of Public Health.
“Pan and colleagues, in Taiwan, found that 4,000 cases of tuberculosis had had more frequent health care visits prior to developing tuberculosis than 17,000 controls, suggesting that avoiding unnecessary hospital visits may protect against contracting tuberculosis.” Dr. Alfredo Morabia, the Editor-in-Chief of the American Journal of Public Health, commented on the Taiwan study in the journal’s podcast.
Dr. Hsien-Ho Lin, an associate professor from NTU College of Public Health and the senior author of the study, said that “our finding does not mean that people should stop going to the hospitals, but every effort should be made to discourage unnecessary hospital shopping. Infection control in all health care settings should be intensified and active case finding of tuberculosis patients should be strengthened.”