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Medical and cost-effectiveness of TB detection by fluorography using double reading of chest films Print
Friday, 27 December 2013

S.A. Sterlikov1, S.G. Rudnev2, O.V. Obukhova1
1 Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
2 Research Institute of Phthisiopulmonology, First Moscow State Medical University named after I.M. Sechenov, Moscow

Abstract. Background. Fluorography is the main method of detecting tuberculosis in the Russian Federation. However, efficiency of this method is insufficient. The detection rate of TB patients with fluorography in 2009-2012 was 0.79-0.71 per 1,000 patients (at optimum 1-2 per 1,000). Double reading of chest films is one of the methods to improve efficiency of fluorography.

The aim of the study was to analyze medical and economic efficiency of organizing double reading of chest films.

Methods. Survey of 236 primary health care organizations was conducted in 2009. Double reading of chest films was used in 8.9% of medical institutions serving 13.7% of the population sample. Single reading was used in 25.4% of the institutions for 27.7% of the population sample. The remaining institutions used the dual reading of chest films.

The study shows that universal implementation of the double reading of chest films in Russia can improve detection of tuberculosis through routine chest X-rays by 19% (up to 0.94 per 1,000 tested), as well as increase the share of newly TB cases detected during routine chest X-rays by 19% (up to 65.9%).

It has been calculated that prime cost of X-ray per capita will increase from 46.12 to 49.51 rubles (1.54 to 1.65 USD) (in 2009 prices), while the total primecost of detecting a TB patient with fluorography will decrease by 5663.86 rubles (188.8 USD) (9.8%) and will add up to 52334.39 rubles (1744.48) USD per patient.

Scope of application: primary health care.

Keywords: routine examinations for tuberculosis; fluorography; double reading; economic efficiency of fluorography; prime cost of TB detection per patient.


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