Why do tuberculosis suspects bypass local services to attend tuberculosis sanatorium?

Area of Science:

• Public Health
• Respiratory Medicine
• Health Services Research

Background:

• The Government Hospital of Thoracic Medicine (GHTM) in Tambaram, Tamil Nadu, continues to attract patients nationwide for chest symptoms.
• This occurs despite the established country-wide availability of Revised National Tuberculosis Control Programme (RNTCP) services.

Purpose of the Study:

• To investigate and document the specific reasons why patients with chest symptoms choose to attend GHTM.
• To understand patient motivations for seeking healthcare at this specialized institution.

Main Methods:

• A prospective observational study was conducted from January to March 2006.
• A simple random sample of tuberculosis suspects attending the GHTM out-patient department were interviewed using a semi-structured schedule.
• Data collected included demographic, socio-economic characteristics, and reasons for attending GHTM.

Main Results:

• 2,023 respondents were studied; 56% males, 67% under 45 years, 63% literate, with an average annual family income of Rs 25,000.
• Key reasons for attendance included the center's popularity (82%), perceived quality of treatment (52%), referrals from past patients (36%), and expectation of specialized care (22%).

Conclusions:

• GHTM's historical reputation as a "TB sanatorium" significantly influences patient choices, even with accessible local RNTCP services.
• There is a clear need to enhance community awareness regarding the availability and accessibility of free RNTCP diagnostic and treatment facilities.