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Organization of TB services in Hong Kong MEDICAL CARE FOR TUBERCULOSIS :. Tuberculosis is one of the 29 diseases in Hong Kong which must be notified by law. Notification is important both for initiation of contact tracing, and for providing information about the epidemiology of tuberculosis. Not all doctors are aware of their responsibility, however, and notification data are likely to be incomplete. Information about deaths attributed to tuberculosis is collected from death certificates. These data may also be incomplete or inaccurate. Despite these inadequacies, surveillance data do provide some indication of the size of the problem: Surveillance data for 2002:
These data do not tell us much about the extent of morbidity due to tuberculosis in Hong Kong: for example, the proportion of patients with tuberculosis who required admission to hospital, the duration of treatment and follow-up required by patients. Services provided for patients with tuberculosis in Hong Kong are comprehensive. The main service providers are the chest clinics and the hospitals specialising in treatment of chest disease (Figure). Patients may also attend other primary care settings including general out-patient clinics (GOPCs), Accident and Emergency Departments (A&E) and private practitioners. They may be referred to specialist out-patient departments and private hospitals. It is important to be aware of these potential referral patterns when you are interviewing patients in either the hospital setting. Service activity data provide some indication of the volume of health care provided to patients with tuberculosis. These data are, however, difficult to interpret: hospital in-patient data are based on episodes of admission and do not tell us anything about the proportion of patients requiring admission and which patients required more than one admission. Chest clinic activity data indicate how many new patients were seen, but do not tell us how often each patient attended. Service activity data for 2000 (approximate):
Figure: Services available to patients with tuberculosis in Hong Kong, and potential referral patterns
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