武汉市2008－2017年结核病患者就诊延迟情况及影响因素分析

王晓君; 付谦; 张正斌; 鲁周琴; 田丹; 南晶; 王坚杰; 李月华

Abstract

王晓君,付谦,张正斌,鲁周琴,田丹,南晶,王坚杰,李月华.武汉市2008－2017年结核病患者就诊延迟情况及影响因素分析[J].Chinese journal of Epidemiology,2019,40(6):643-647

武汉市2008－2017年结核病患者就诊延迟情况及影响因素分析

Delay on care-seeking and related influencing factors among tuberculosis patients in Wuhan, 2008-2017

Received:January 07, 2019

DOI：10.3760/cma.j.issn.0254-6450.2019.06.008

KeyWord: 结核病就诊延迟影响因素

English Key Word: Tuberculosis Patient delay Influencing factors

FundProject:

Author Name	Affiliation	E-mail
Wang Xiaojun	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China
Fu Qian	School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Zhang Zhengbin	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China
Lu Zhouqin	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China
Tian Dan	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China
Nan Jing	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China
Wang Jianjie	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China
Li Yuehua	Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China	664748060@qq.com

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Abstract:

目的分析2008－2017年武汉市结核病患者就诊延迟行为特征、变化趋势及其影响因素，为结核病防治提供依据。方法利用中国疾病预防控制信息系统结核病管理信息系统，收集2008－2017年武汉市64 208例0～95岁结核病患者病案信息，采用非条件多因素logistic回归模型分析结核病患者就诊延迟的影响因素。结果 2008－2017年武汉市结核病患者的就诊天数为M=10（P₂₅～P₇₅：3～28）d，就诊延迟率为52.5%（33 703/64 208），总体呈下降趋势（趋势χ²=10.64，P<0.001）。结核病就诊延迟者主要为男性，女性、≥65岁组所占的构成比逐渐增长。多因素logistic回归分析结果显示，远城区（与近城区相比，OR=1.29，95% CI：1.25～1.35）、≥45岁组（45～、≥65岁组与<25岁组相比，OR=1.22，95% CI：1.15～1.29；OR=1.30，95% CI：1.22～1.39）是结核病患者就诊延迟的危险因素，职业、患者来源和患者分类也是结核病患者就诊延迟的影响因素。结论 2008－2017年武汉市结核病患者的就诊延迟率总体呈下降趋势。应重点关注结核病患者中的女性和中老年就诊延迟者。

English Abstract:

Objective To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017. Methods Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study. Results Days of delay among TB patients appeared as M=10 (P₂₅-P₇₅:3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend χ²=10.64, P<0.001), but the proportions of women and ≥ 65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as:patients living far away from the city vs. near the city (OR=1.29, 95%CI:1.25-1.35), and age above 45 years vs. younger than 25 years (the age 45-64 years group vs. aged less than 25 years group, OR=1.22, 95%CI:1.15-1.29; the age 65 or above group vs. aged less than 25 years group, the OR=1.30, 95%CI:1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue. Conclusions Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.

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