初治涂阳肺结核社会经济学调查及延误治疗的相关因素分析  

Socioeconomics of new smear-positive pulmonary tuberculosis and related factors of delayed treatment

作　　者：孔荣[1] 陈亮[1] 黄致信 KONG Rong;CHEN Liang;HUANG Zhi-xin(Renhe Hospital Affiliated to Sanxia University,Yichang,Hubei 445001,China)

机构地区：[1]三峡大学附属仁和医院

出　　处：《现代预防医学》2020年第1期88-92,共5页Modern Preventive Medicine

摘　　要：目的调查初治涂阳肺结核社会经济学情况,了解涂阳肺结核延误治疗状况,为结核病防控提供依据。方法随机抽取武汉市结核病防治所住院治疗的初治涂阳肺结核患者200例,调查一般人口学资料、社会经济因素、就医可行性、就医前对结核病知识了解程度等,按是否延误治疗分组,总结延误治疗影响因素。结果女性(51.72%)、费用支出占总支出比例超过20%(24.14%)、存在高结核病经济压力患者(58.62%)、至最近综合医疗机构时间≥15 min(75.86%)、不了解结核病知识宣传(72.41%)、正规治疗前就诊1~2次患者(55.17%)治疗延误发生率高于男性、费用支出占总支出比例低于20%、无结核病经济压力、至最近综合医疗机构时间<15 min、了解结核病知识宣传及就诊次数3~4次患者(x^2=4.748、4.200、7.918、4.679、3.928、4.245,P均<0.05);多因素分析显示性别(OR=2.782,95%CI:1.635~4.731)、费用支出占总支出比例(OR=8.767,95%CI:4.380~17.546)、结核病经济压力(OR=9.728,95%CI:3.170~29.848)、至最近综合医疗机构时间(OR=4.627,95%CI:1.473~14.536)、是否了解结核病知识宣传(OR=2.678,95%CI:1.058~6.780)均为导致治疗延误的相关因素(P均<0.05)。结论初治涂阳肺结核患者整体社会经济水平较低,女性、费用支出占总支出比例高、结核病经济压力大、至最近综合医疗机构时间长、对结核病知识知晓率低的患者治疗延误风险较大。Objective To investigate the socioeconomics of new smear-positive pulmonary tuberculosis,and to understand its delayed treatment status,so as to provide evidence for prevention and control of tuberculosis.Methods A total of 200 patients with new smear-positive pulmonary tuberculosis in Wuhan Tuberculosis Control Center were randomly selected.The general demographic data,socioeconomic factors,medical feasibility and knowledge mastery of tuberculosis before medical treatment were investigated.The grouping was performed according to whether had the delayed treatment or not,and the influencing factors related to delayed treatment were summarized.Results The incidence rates of delayed treatment in patients with features of women(51.72%),proportion of expenses in total expenditures more than 20%(24.14%),high tuberculosis economic pressure(58.62%),time to the nearest comprehensive medical institution≥15 min(75.86%),no mastery of tuberculosis knowledge publicity(72.41%)and visiting time of 1 to 2 before formal treatment(55.17%)were higher than those in patients with features of men,proportion of expenses in total expenditure less than 20%,no tuberculosis economic pressure,time to the nearest comprehensive medical institution<15 min,understanding of tuberculosis knowledge publicity and visit frequency of 3 to 4(x^2=4.748,4.200,7.918,4.679,3.928,4.245,all P<0.05).Multivariate analysis showed that gender(OR=2.782,95%CI:1.635~4.731),proportion of expenses in total expenditure(OR=8.767,95%CI:4.380~17.546),tuberculosis economic pressure(OR=9.728,95%CI:3.170~29.848),time to the nearest comprehensive medical institution(OR=4.627,95%CI:1.473~14.536),and understanding of tuberculosis knowledge publicity(OR=2.678,95%CI:1.058~6.780)were all relevant factors to treatment delay(all P<0.05).Conclusion The overall socioeconomic level is lower in patients with new smear-positive pulmonary tuberculosis,and the risk of treatment delay is higher in patients with features of women,a high proportion of expenses in total expenditure,high tub

关 键 词：肺结核 初治 涂阳 社会经济学 延误 治疗 

分 类 号：R181.23[医药卫生—流行病学]