2017—2022年西安市肺结核患者就诊延迟及影响因素分析  

Treatment-seeking delay and related influencing factors among tuberculosis patients in Xi′an from 2017 to 2022

作　　者：杨春龙 王艳飞[2] 陈明亭[3] YANG Chunlong;WANG Yanfei;CHEN Mingting(Department of Disease Prevention and Control,Xi'an Chest Hospital,Xi'an 710100,Shaanxi Province,China;Department of Tuberculosis Prevention and Control,Xi'an Center for Disease Control and Prevention,Xi'an 710054,Shaanxi Province,China;National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]西安市胸科医院疾病预防控制科,西安710100 [2]西安市疾病预防控制中心结核病预防控制科,西安710054 [3]中国疾病预防控制中心结核病预防控制中心,北京102206

出　　处：《预防医学情报杂志》2025年第1期1-7,19,共8页Journal of Preventive Medicine Information

摘　　要：目的分析2017—2022年西安市肺结核患者就诊延迟的现状及影响因素,为制定相关防控措施,减少患者就诊延迟提供科学依据。方法对西安市2017—2022年肺结核患者就诊延迟现状进行描述,并采用多因素Logistic回归模型分析肺结核患者就诊延迟的影响因素,检验水准α=0.05。结果2017—2022年西安市肺结核患者就诊延迟天数中位数为24(P_(25)~P_(75):10~56)d,就诊延迟率为45.10%(12822/28429),就诊延迟率在疫情前3年(2017—2019年)逐年下降,疫情后3年(2020—2022年)先上升后下降,不同性别及年龄组的就诊趋势总体基本相同;多因素Logistic回归分析结果显示,患者民族为其他(OR=0.62),诊断结果为无病原学结果(OR=0.70)与就诊延迟呈负相关(P均<0.05);疫情后(OR=1.14)就诊延迟风险高于疫情前;女性(OR=1.07)就诊延迟风险高于男性;45岁及以上年龄组就诊延迟风险升高;患者职业中其他职业的患者与幼托儿童和学生相比,就诊延迟风险升高;患者来源为直接就诊(OR=3.11)、转诊(OR=5.34)、追踪(OR=8.22)与就诊延迟呈正相关。结论2017—2022年西安市肺结核患者就诊延迟较为普遍,女性、中老年、被动发现的肺结核患者就诊延迟率较高,应采取综合措施减少就诊延迟的发生。Objective To analyze the current situation of treatment-seeking delay and influencing factors of pulmonary tuberculosis patients in Xi′an from 2017 to 2022,and to provide a theoretical basis for the formulation of relevant prevention and control measures to reduce patient delays.Methods The current situation of treatment-seeking delay among pulmonary tuberculosis patients was described in Xi′an from 2017 to 2022.A multivariate logistic regression model is used to analyze the influencing factors of treatment-seeking delay,with a significance level of P<0.05.Results From 2017 to2022,the median days of patient delay in seeking medical treatment for pulmonary tuberculosis patients in Xi′an was 24 days,ranging from 10 to 56 days.The overall treatment-seeking delay rate was 45.10%(12822/28429).The treatment-seeking delay rate showed a decreasing trend in the three years before the epidemic(2017-2019)and an initial increase followed by a decrease in the three years after the epidemic(2020-2022).The patient delay rate in different genders and age groups exhibited similar trend to the overall pattern.Multivariate logistic regression analysis indicated that patients of ethnicities classified as“other”(OR=0.62)and a diagnostic outcome of no microbiological evidence(OR=0.70)had a negative correlation with treatment-seeking delay(P<0.05).The risk of patient delay after epidemic(OR=1.14)was higher than that before the epidemic.Females(OR=1.07)had a higher risk of treatment-seeking delay compared to males.The age group of 45and above had an increased risk of treatment-seeking delay.Patients with occupations classified as“other”have a higher risk of treatment-seeking delay compared to preschool children and students.The source of patient,whether through direct visits(OR=3.11),referrals(OR=5.34),or tracking(OR=8.22),was positively correlated with treatment-seeking delay.Conclusions From 2017 to2022,treatment-seeking delay among pulmonary tuberculosis patients was relatively common in Xi′an.Higher rates of treatmen

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]