2019—2023年丽水市老年肺结核患者就诊延迟情况及影响因素分析  

Patient delay and related factors among elderly pulmonary tuberculosis patients in Lishui City,2019—2023

作　　者：陈晓蕾[1] 陶桃[1] 凡鹏飞[1] 李秋华[1] 张海芳[1] Chen Xiaolei;Tao Tao;Fan Pengfei;Li Qiuhua;Zhang Haifang(Center for Disease Control and Prevention,Lishui 323000,China)

机构地区：[1]丽水市疾病预防控制中心,丽水323000

出　　处：《中国防痨杂志》2024年第11期1380-1387,共8页Chinese Journal of Antituberculosis

基　　金：丽水市科技计划项目(2023SJZC008,2022SJZC062)

摘　　要：目的:了解2019—2023年丽水市老年肺结核患者就诊延迟现状及其影响因素,为制定和调整结核病防治措施提供依据。方法:通过“中国疾病预防控制信息系统”子系统“结核病信息管理系统”收集2019—2023年登记的现住址为丽水市≥60岁肺结核患者的病案信息,共2436例,包括个人基本信息和诊疗情况等,分析患者的就诊延迟时间和就诊延迟率分布情况和变化趋势,采用多因素logistic回归模型分析其影响因素。结果:老年肺结核患者就诊延迟时间的中位数(四分位数)为30(12,77)d,总体就诊延迟率为70.11%(1708/2436)。2019—2023年老年肺结核患者就诊延迟率分别为65.02%(290/446)、62.75%(288/459)、67.39%(310/460)、74.00%(353/477)、78.62%(467/594),总体呈上升趋势,差异有统计学意义(χ^(2)_(趋势)=42.993,P<0.001)。多因素logistic回归分析显示,登记年份为2022年(OR=1.538,95%CI:1.149~2.059)和2023年(OR=2.108,95%CI:1.584~2.805)、首诊地区为本市(OR=3.931,95%CI:1.602~9.650)、现住址为松阳县(OR=1.569,95%CI:1.045~2.357)是就诊延迟的危险因素,现住址为云和县(OR=0.433,95%CI:0.269~0.700)、景宁县(OR=0.412,95%CI:0.254~0.667)、龙泉市(OR=0.402,95%CI:0.260~0.621)是就诊延迟的保护因素。结论:丽水市老年肺结核患者就诊延迟率高,且呈上升趋势,需重点关注本市就诊者及松阳县患者,并采取有效措施,降低老年肺结核患者就诊延迟率。Objective:To analyze the trend and related factors of patient delay among elderly pulmonary tuberculosis(PTB)patients in Lishui City,and to provide basis for the formulation and adjustment of tuberculosis control measures.Methods:Data of 2436 cases of elderly PTB patients in Lishui City from 2019 to 2023 was extracted from the Tuberculosis Management Information System,a Sub-system of China Information System for Disease Control and Prevention,including medical records,diagnosis and treatment information,etc.,to analyze the distribution and change trend of their patient delay time and delay rate.Multivariable logistic regression was conducted to identify influencing factors.Results:From 2019 to 2023,the median(Q1,Q3)patient delay time was 30(12,77)days.The overall patient delay rate was 70.11%(1708/2436).The delay rates from 2019 to 2023 were 65.02%(290/446),62.75%(288/459),67.39%(310/460),74.00%(353/477)and 78.62%(467/594),respectively,showing an statistically significant upward trend(χ^(2)trend=42.993,P<0.001).Multivariable logistic regression showed that registration year being 2022(OR=1.538,95%CI:1.149-2.059)or 2023(OR=2.108,95%CI:1.584-2.805),firstly diagnosed in Lishui City(OR=3.931,95%CI:1.602-9.650),and current address being Songyang County(OR=1.569,95%CI:1.045-2.357)were risk factors for patient delay.Current address being Yunhe County(OR=0.433,95%CI:0.269-0.700),Jingning County(OR=0.412,95%CI:0.254-0.667),and Longquan City(OR=0.402,95%CI:0.260-0.621)were protective factors for patient delay.Conclusion:The patient delay rate in Lishui City was high,and showed an increasing trend.It is necessary to focus on local patients and patients in Songyang County,and take effective measures to reduce the delay rate of elderly tuberculosis patients.

关 键 词：结核 肺 因素分析 丽水市 

分 类 号：R521[医药卫生—内科学] R181.2[医药卫生—临床医学]