上海市普陀区非户籍人口结核病诊断延误及其影响因素研究  

Study on factors causing the delay of access to tuberculosis diagnosis and its influencing factors in migrating tuberculosis patients in Putuo district, Shanghai

作　　者：邓海巨[1] 郑亦慧 张宇艳[1] 徐飚[2] 

机构地区：[1]上海市普陀区疾病预防控制中心,200062 [2]复旦大学公共卫生学院

出　　处：《中华流行病学杂志》2006年第4期311-315,共5页Chinese Journal of Epidemiology

摘　　要：目的了解上海市普陀区非户籍人口结核病诊断延误情况,分析影响非户籍人口结核病诊断延误的人口学和社会经济学因素。方法对146例新确诊的非户籍人口结核病患者,采用回顾性队列研究方法了解患者延误、医生延误及诊断延误的时间,分析其影响因素。结果患者延误时间的中位数是19(7-33．5)天,医生延误时间的中位数是5(2．5-10)天,患者延误时间是医生延误时间的3．8倍。诊断延误时间的中位数是31(11-59)天,女性比男性发生诊断延误的危险性高(OR= 3．226,P<0．05);年收入<5000元者比≥10 000元者发生诊断延误的危险性高(OR=11．958,P< 0．01);痰涂片阴性者发生诊断延误的危险性低于阳性者(OR=0．280,P<0．05)。结论患者延误是诊断延误的主要部分,非户籍人口中女性、低文化程度的结核病患者其医疗可及性更容易受到影响。Objective To describe factors causing the delay of diagnosis among non-resident tuberculosis（TB） patients and to study its implications from demographic,socio-economie aspects in order to provide information to policy makers for TB control programs in Shanghai. Methods A historical cohort study through questionnaire interview was conducted in 146 newly diagnosed TB patients. The questionnaire covered the general information of subjects and information on patients＇ health care seeking experiences from the first symptom to the TB diagnosis in health facilities. Index adopted to reflect the access to TP, diagnosis would include the days due to delayed diagnosis consisting the days from both patient＇s and doctor＇s responsibilities. Results The median days due to patients＇ delay was 19（7 33,5） days,whlch was 3.8 times longer than 5（2.5-10） days caused by doctor＇s. The median of total diagnostic delay was 31 （11-59） days. Female TB patients,patients with lower than annual 5000 Yuan income had an increased risk of a longer diagnostic delay with an OR of 3.226 and 11.958 relatively. Smear positive patients had a shorter delay （ OR = 0. 280, P 〈 0.05）. Conclusion Delayed diagnosis was mostly caused by the patients,suggesting that TB control strategy for non-residents should aim at improving the access to TB diagnosis among patients with lower income and female non-residents.

关 键 词：结核病 诊断延误 非户籍人口 

分 类 号：R52[医药卫生—内科学]