Ensuring accountability: the contribution of the cohort review method to tuberculosis control in New York City

Int J Tuberc Lung Dis. 2006 Oct;10(10):1133-9.


Setting: In 1993, the New York City (NYC) Bureau of Tuberculosis Control developed the cohort review process as a quality assurance method to track and improve patient outcomes.

Methods: The Bureau Director reviews every tuberculosis (TB) case quarterly in a multi-disciplinary staff meeting. In 2004 we also began collecting details on issues identified at cohort review to quantify how this process directly impacts TB control efforts.

Results: From 1992 to 2004, NYC TB cases decreased by 72.7% and treatment success rates significantly increased by 26.7%. Implementing the cohort review was key to improving case management, thus leading to these results. For the 1039 patients in 2004, 596 issues were identified among 424 patients; 55.0% were incorrect, unclear or unknown patient information, 13.8% were treatment issues, 12.4% were case management issues and 10.6% were incomplete contact investigations. Most (76.5%) issues were addressed within 30 days of the cohort reviews.

Conclusion: A systematic review of every TB case improves the quality of patient information, enhances patient treatment and ensures accountability at all levels of the TB control program.

MeSH terms

  • Case Management
  • Contact Tracing / statistics & numerical data
  • Disease Notification / statistics & numerical data*
  • Humans
  • New York City / epidemiology
  • Organizational Objectives
  • Outcome and Process Assessment, Health Care* / methods
  • Outcome and Process Assessment, Health Care* / organization & administration
  • Program Development
  • Program Evaluation / methods
  • Public Health Administration / standards
  • Quality Assurance, Health Care / methods*
  • Quality Assurance, Health Care / organization & administration
  • Social Responsibility
  • Tuberculosis / epidemiology
  • Tuberculosis / prevention & control*
  • Tuberculosis / transmission