STUDIES ON PRESENT STATUS OF DEATH AMONG TUBERCULOSIS PATIENTS REPORTED TO ONE HEALTH CENTER IN TOKYO METROPOLIS
Part II Studies on Registration Status
1977 Volume 52 Issue 9 Pages 417-422
Details
1977 Volume 52 Issue 9 Pages 417-422
Out of 593 cases reported as tuberculosis death to Tanashi Health Center, Tokyo, during the period 1 January 1962 to 31 December 1972, 202 cases or 34. 1% were not registered as Tuberculosis patients at the Health Center, in spite of compulsory reporting system under the tuberculosis Control Law in Japan (Table 1). To know the characteristics of the patients who were not registered before death, sex, age, occupation, place of death and causes of death of non-registered cases were compared with those of registered ones (Table 1, 2, 3 and 4), and no difference was found between registered and non-registered cases concerning above-mentioned background factors.
The reasons why the patients were not registered as tuberculosis at health centers were analyzed by sending inquiries to the attending physicians who had prepared the death certificate for 31 non-registered cases died of tuberculosis during 1971 and 1972. The reasons of no-regis tration were summerized as follows:
1) Seventeen case (58.6%) were registered at other health centers. Out of them 15 cases were registered at the health centers of the area where the patients were receiving services by the Daily Life Security Law. Two other cases died before transfering the registration card to the present health center from the former one.
2) Twelve cases (41.4%) were not reported. Out of them five cases were considered by the attending physicians to have been reported already by the former doctors, but actually not. Three of them died shortly after the admission or doctor's visit and the doctors considered that such advanced cases should be reported already and were not reported. Two cases were examined after death.
3) Out of non-registered 12 cases, seven were not reported because the physicians considered that there was no economical merit to the patients as the expenses for treatment were completely covered by health insurance or Veterans Security Law.
It is worth mentioning that more than 10% of patients, including very severe cases were not reported to any health centers. To carry out contact examination of the family and other close contacts of the patients more completely, the author considered that the importance of reporting should be stressed more and more to all the physicians so as to have 100% reporting of tuberculosis in the future.
