TY - JOUR
T1 - Private sector tuberculosis prevention in the US
T2 - Characteristics associated with interferon-gamma release assay or tuberculin skin testing
AU - Stockbridge, Erica L.
AU - Miller, Thaddeus L.
AU - Carlson, Erin K.
AU - Ho, Christine
N1 - Publisher Copyright:
© This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2018/3
Y1 - 2018/3
N2 - Objective To determine whether latent tuberculosis infection risk factors are associated with an increased likelihood of latent tuberculosis infection testing in the US private healthcare sector. Data source A national sample of medical and pharmacy claims representing services rendered January 2011 through December 2013 for 3,997,986 commercially insured individuals in the US who were 0 to 64 years of age. Study design We used multivariable logistic regression models to determine whether TB/LTBI risk factors were associated with an increased likelihood of Interferon-Gamma Release Assay (IGRA) or Tuberculin Skin Test (TST) testing in the private sector. Principal findings 4.31% (4.27–4.34%) received at least one TST/IGRA test between 2011 and 2013 while 1.69% (1.67–1.72%) received a TST/IGRA test in 2013. Clinical risk factors associated with a significantly increased likelihood of testing included HIV, immunosuppressive therapy, exposure to tuberculosis, a history of tuberculosis, diabetes, tobacco use, end stage renal disease, and alcohol use disorder. Other significant variables included gender, age, asthma, the state tuberculosis rate, population density, and percent of foreign-born persons in a county. Conclusions Private sector TST/IGRA testing is not uncommon and testing varies with clinical risk indicators. Thus, the private sector can be a powerful resource in the fight against tuberculosis. Analyses of administrative data can inform how best to leverage private sector healthcare toward tuberculosis prevention activities.
AB - Objective To determine whether latent tuberculosis infection risk factors are associated with an increased likelihood of latent tuberculosis infection testing in the US private healthcare sector. Data source A national sample of medical and pharmacy claims representing services rendered January 2011 through December 2013 for 3,997,986 commercially insured individuals in the US who were 0 to 64 years of age. Study design We used multivariable logistic regression models to determine whether TB/LTBI risk factors were associated with an increased likelihood of Interferon-Gamma Release Assay (IGRA) or Tuberculin Skin Test (TST) testing in the private sector. Principal findings 4.31% (4.27–4.34%) received at least one TST/IGRA test between 2011 and 2013 while 1.69% (1.67–1.72%) received a TST/IGRA test in 2013. Clinical risk factors associated with a significantly increased likelihood of testing included HIV, immunosuppressive therapy, exposure to tuberculosis, a history of tuberculosis, diabetes, tobacco use, end stage renal disease, and alcohol use disorder. Other significant variables included gender, age, asthma, the state tuberculosis rate, population density, and percent of foreign-born persons in a county. Conclusions Private sector TST/IGRA testing is not uncommon and testing varies with clinical risk indicators. Thus, the private sector can be a powerful resource in the fight against tuberculosis. Analyses of administrative data can inform how best to leverage private sector healthcare toward tuberculosis prevention activities.
UR - http://www.scopus.com/inward/record.url?scp=85044866059&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0193432
DO - 10.1371/journal.pone.0193432
M3 - Article
C2 - 29590130
AN - SCOPUS:85044866059
SN - 1932-6203
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 3
M1 - e0193432
ER -