CTCA Prioritization Survey

1
CTCA Prioritization Survey

• Analysis provided by
• Jessica Cunningham
• CSTE/CDC Applied Epidemiology Fellow
• OPCS, CDPH TBCB
• With some help from our friend Tony Paz

2
Survey Purpose

• To help the TB Control Community articulate a
  prioritized list of TB Control activities within
  the range of TB Control.
• To advise strained programs of where to cut
  program efforts, in what order to cut.
• Also, to help the TB Control Community track
  where the gaps in TB Control efforts are, as
  budgets shrink and cuts are made.

3
Survey layout

• 42 activities in 12 categories
• Each activity
• Priority High, Medium, Low
• Performance Yes, Reduced, No
• Comments

4
Response

• 27 jurisdictions (44)
• 8 high morbidity gt55 cases 30
• 4 medium morbidity 10-55 cases 15
• 15 low morbidity lt10 cases 55
• Low response for 2 questions
• Format issue, not content
• Question 7
• Question 37

5
Priority scores

• Scoring system higher number is higher priority
• Average of points assigned based on priority
• Low priority 1
• Medium priority 2
• High priority 3
• Range 1.5 2.9

6
High priority activities

• Priority score of 2.8 and above
• Case management for health department patients
  (2.92)
• Contact investigation for health department
  patients (2.88)
• DOT Review/approval TB discharges (2.87)
• Treatment of TB3 for private MD patients (2.85)
• Treatment of TB3 for health department patients
  (2.84)
• DOT for health department patients (2.83)
• DOT for private MD patients (2.81)
• Contact investigation for private MD patients
  (2.81)

7
Low priority activities

• Priority score of 1.7 and below
• Engage in advocacy activities (1.52)
• TB screening for job clearance (1.56)
• Compare program outcome to CDPH objectives (1.60)
• Treatment of LTBI in persons gt35 years (1.63)
• TB screening for school clearance (1.63)
• Conduct patient cohort reviews (1.64)
• TB Control activity - adult (documented
  converters) (1.70)

8
Morbidity and priority scores

9
Reduced activities
10
Reduced activities low morbidity jurisdictions
11
Reduced activities medium/high morbidity
jurisdictions
12
Activities not performed
13
Activities not performed low morbidity
jurisdictions
14
Activities not performed medium/high morbidity
jurisdictions
15
Limitations

• Responding and non-responding jurisdictions may
  differ in priorities and current activity
  performance