[Integration of tuberculosis care into general hospitals in the United States]

In Japan we are now urged to rethink and reform the present ward-centered institutional system of clinical service for tuberculosis (TB). To provide useful information for this rethinking and reform, we performed a literature review of the process of integrating TB service into general hospitals in the US.

Literature review.

The process of integrating TB service into general hospitals in USA began around 1970, and continued until around 1980, when it was almost complete. From the experience and opinions of the authors reviewed, the following points were found to be important to successful integration: establishing an efficient outpatient department, maintaining patients' adherence to treatment, using a long-term care facility for TB patients requiring long-term in-hospital care, planning a program for integration of care fully in advance, individualizing the program according to the region, adopting a phased step-by-step program, educating hospital staff and securing financial support from governments.

The reform of tuberculosis wards in Japan will occur at the same time as the reform of the country's TB control program, and will provide a good opportunity to improve our program.