Domiciliary Treatment of Pulmonary Tuberculosis

The Seton Hospital Home Care Program

¹ Seton Hospital of the Department of Hospitals, City of New York.
² Seton Hospital of the Department of Hospitals, City of New York., Associate Physician, Medical Service. From the Medical Service, Seton Hospital

1) A home care program was inaugurated at Seton Hospital in 1950 to meet an urgent need for beds for the tuberculous. It was soon realized, however, that the program has a definite place in its own right in the management of tuberculosis patients equal in importance to that of occupational therapy, rehabilitation and social service departments of the hospital.

2) The home care program for the tuberculous rests on the assumption that an intelligent, cooperative patient partially restored to health can be treated for part of his long-term illness at home to his ultimate benefit. The home care program has been found most useful for patients undergoing major thoracic surgery. After such operations most patients are able to spend part of the time at home convalescing, a period otherwise spent in the institution. To a lesser extent the program is suited for patients receiving pneumothorax and pneumoperitoneum with effective collapse of the lung as well as patients with spontaneously regressive tuberculosis in whom there is a reasonable expectation that in time the disease will become arrested.

3) Patients with progressive disease, those with persistent tubercle bacilli in the sputum, those in immediate need of surgery or those in need of involved diagnostic and therapeutic procedures are not suited for the home care program. Neither are custodial patients or those who ordinarily qualify for the out patient department.

4) Two basic criteria are utilized in the conduct of the home care program. First, the condition of the patient must have improved sufficiently to permit continued treatment at home; secondly, home conditions must be adequate.

5) Our experience in a city hospital caring for indigent patients has shown that a home care program for the tuberculous is feasible and desirable from the viewpoint of the patients' welfare as well as from the viewpoint of community needs.