2012—2021年烟台市肺结核患者就诊延迟趋势及影响因素分析  

Health-care seeking delay and influencing factors of pulmonary tuberculosis patients,Yantai,2012-2021

作　　者：甄丽丽 路立勇 任艳 王淑蕾[1] 周静 任晓华 何荟荟 刘靖宇[1] 王曰雷[1] 姜杰 ZHEN Li-li;LU Li-yong;REN Yan;WANG Shu-lei;ZHOU Jing;REN Xiao-hua;HE Hui-hui;LIU Jing-yu;WANG Yue-lei;JIANG Jie(Yantai Center for Disease Control and Prevention,Yantai,Shandong 264003,China;不详)

机构地区：[1]烟台市疾病预防控制中心,山东烟台264003 [2]山东大学卫生管理与政策研究中心 [3]山东第二医科大学公共卫生学院 [4]烟台市牟平区疾病预防控制中心

出　　处：《现代预防医学》2024年第8期1507-1511,1523,共6页Modern Preventive Medicine

基　　金：山东省卫生健康委政策研究课题(WZY202395);山东省学校卫生协会课题(SDWS2023197)。

摘　　要：目的 分析山东省烟台市肺结核患者就诊延迟趋势及影响因素,为制定结核病防控措施提供参考依据。方法 对2012—2021年烟台市肺结核患者就诊延迟现状及变化趋势进行描述,采用多因素logistic回归模型分析肺结核患者就诊延迟的影响因素。结果 2012—2021年烟台市肺结核患者就诊天数中位数为28(10,61)天;肺结核患者就诊延迟率为66.47%,整体呈上升趋势(χ趋势2=87.638,P<0.001)。多因素logistic回归分析结果显示,与61岁以上年龄组、农民、其他来源、流动人口、病原学阴性患者相比,≤20岁(OR=0.65,95%CI:0.56~0.75)、21~40岁(OR=0.80,95%CI:0.74~0.88)、公共场所及商业服务者(OR=0.66,95%CI:0.49~0.90)、儿童及学生(OR=0.73,95%CI:0.61~0.87)、企事业职工(OR=0.80,95%CI:0.66~0.97)、其他体力劳动(OR=0.83,95%CI:0.74~0.92)、本地人口(OR=0.68,95%CI:0.60~0.78)是就诊延迟的保护因素,41~60岁(OR=1.12,95%CI:1.03~0.12)、因症就诊(OR=4.30,95%CI:3.63~5.10)、转诊(OR=3.40,95%CI:2.87~4.03)、追踪(OR=5.59,95%CI:4.69~6.66)、病原学阳性(OR=1.33,95%CI:1.24~1.43)是就诊延迟的危险因素。结论 2012—2021年烟台市肺结核患者就诊延迟率总体呈上升趋势,年龄、户籍地、职业、患者来源、患者分类是肺结核患者就诊延迟的影响因素。Objective To analyze the trend of health-care seeking delay and influencing factors among pulmonary tuberculosis patients and provide a reference basis for prevention and control measures in Yantai.Methods The current status and trend of health-care seeking delay among pulmonary tuberculosis patients in Yantai from 2012 to 2021 were described.Additionally,multivariate logistic regression was employed to analyze the influencing factors of health-care seeking delay.Results From 2012 to 2021,the median of health-care seeking days was 28(10,61)days.The health-care seeking delay rate was 66.47%and exhibited an upward trend(χ^(2)trend=87.638,P<0.001).Multivariate logistic regression analysis revealed that compared with the age group over 61 years old,the following factors were associated with reduced risk for delayed treatment:individuals under 20 years old(OR=0.65,95%CI:0.56-0.75),aged 21-40 years(OR=0.80,95%CI:0.74-0.88),serving public places and businesses(OR=0.66,95%CI:0.49-0.90),children and students(OR=0.73,95%CI:0.61-0.87),employees of enterprises and institutions(OR=0.80,95%CI:0.66-0.97),engaged in other physical labor(OR=0.83,95%CI:0.74-0.92),and belonging to the native population(OR=0.68,95%CI:0.60-0.78).On the other hand,the age group of 41-60 years old(OR=1.12,95%CI:1.03-1.22),symptomatic treatment(OR=4.30,95%CI:3.63-5.10),referral(OR=3.40,95%CI:2.87-4.03),follow-up(OR=5.59,95%CI:4.69-6.66),and pathogen positive results(OR=1.33,95%CI:1.24-1.43)were identified as risk factors for delayed treatment.Conclusion The health-care seeking delay rate among tuberculosis patients showed an upward trend from 2012 to 2021 in Yantai.Medical institutions should pay attention to the wrinkly or elderly,passive detection,and pathogen positive patients regarding the health-care seeking delay.

关 键 词：肺结核 就诊延迟 影响因素 

分 类 号：R521[医药卫生—内科学]