Factors associated with death among tuberculosis patients in Taiwan

Objectives: Tuberculosis has been an important topic in public health controlling and preventing in Taiwan. Many research concluded that the mortality rate for TB in Taiwan did not significant improved after several policies implemented. Therefore, the study is going to explore the risk factors for death in Tuberculosis in Taiwan. Methods: National Health Insurance Research Dataset from 2004 to 2008 has been used to evaluate the trend of mortality rate for tuberculosis in Taiwan. Descriptive analysis and bivariate analysis were conducted to find the risk factors for death in TB in Taiwan. Logistic regression analyses was also performed to estimate the probability of death from treatment. Results: During years 2004 and 2008, total of 144,841 new TB cases with 32,166 patients died. Patients with different age, gender, different city (city development level), different hospital (hospital ownership, hospital level), and different disease characteristics (comorbidity level, interrupt from treatment, with major illness) will have different mortality rate and survival days. From regression analysis, the study found that patients' age, gender, insured amount, patients' location, hospital characteristics (hospital ownership, hospital level), and disease characteristics (comorbidity level, interrupt from treatment, with major illness) will affect patients' mortality rate. Conclusions: Since DOTS system, pay-for-performance system, and case manager system were came into the standard treatment procedure in TB, the interruption rate, mortality rate of TB will be improved. The important issues in decreasing TB's mortality rate will be improving patients' knowledge and habits, including compliance with physicians.