2017—2022年武汉市肺结核患者就诊延迟情况及影响因素分析  

Analysis of the delayed health-seeking behavior and its influencing factors among pulmonary tuberculosis patients in Wuhan,2017—2022

作　　者：余爱平 张正斌 张泽方 陶志阳[1] 忻骥 鲁周琴 王丽娜 谢耀辉 黄祥虎 周萌 王甜甜 李月华 YU Aiping;ZHANG Zhengbin;ZHANG Zefang;TAO Zhiyang;XIN Ji;LU Zhouqin;WANG Lina;XIE Yaohui;HUANG Xianghu;ZHOU Meng;WANG Tiantian;LI Yuehua(Infectious Disease Prevention and Control Department,Wuhan Dongxihu Disease Control and Prevention Center,Wuhan,Hubei430040,China;不详)

机构地区：[1]武汉市东西湖区疾病预防控制中心传染病防制科,湖北武汉430040 [2]武汉市结核病防治所结核病控制科 [3]郑州轻工业大学计算机与通信工程学院 [4]武汉市精神卫生中心 [5]武汉市东西湖区结核病防治所

出　　处：《中国预防医学杂志》2025年第1期32-36,共5页Chinese Preventive Medicine

基　　金：国家自然科学青年基金项目(42201490);湖北省自然科学基金科研项目(2022CFB176);湖北省卫生健康委员会科研项目(WJ2023F054)。

摘　　要：目的分析2017—2022年武汉市结核病患者病案信息,了解肺结核患者就诊延迟情况及其影响因素,为调整结核病防控策略,及时发现结核病患者提供方向。方法收集“中国结核病管理信息系统”2017—2022年武汉市结核病患者的病案信息,分析患者求医就诊情况,采用二分类logistic回归进行就诊延迟影响因素分析。结果2017—2022年武汉市登记肺结核患者33731例,肺结核登记率从2017年的56.21/10万逐渐降低至2022年的37.88/10万,年递降为6.37%。患者就诊天数中位数为11(3,27)d,存在就诊延迟患者16019例(47.49%)。2017—2022年肺结核患者就诊延迟率总体呈下降趋势(χ^(2)=0.142,P=0.706);多因素logistic回归分析结果显示,年长(45~<60岁:OR=1.23,95%CI:1.04~1.46;≥60岁:OR=1.37,95%CI:1.15~1.63)、远城区(OR=1.27,95%CI:1.21~1.33)以及就诊来源为转诊(OR=1.17,95%CI:1.05~1.30)、追踪(OR=1.38,95%CI:1.24~1.55)为就诊延迟的主要影响因素,而相对于职业为农、林、牧、渔业生产人员,其他职业是患者就诊及时的保护因素(OR=0.52~0.70,95%CI:0.45~0.85)。结论武汉市肺结核患者就诊延迟总体呈下降趋势,但仍有较大改善的空间,卫生行政部门需要制定针对性的结核病防治策略,引导结核病患者及时求医就诊,减少延误时间。Objective By analyzing the medical record information of registered tuberculosis patients in Wuhan,2017—2022,we can understand the delay of health-seeking behavior and its influencing factors among pulmonary tuberculosis patients to provide a direction for improving tuberculosis prevention and control strategies and timely detection of tuberculosis patients.Methods The medical record information of tuberculosis patients in Wuhan from 2017 to 2022 in China was collected from the tuberculosis management information system.The healthseeking behavior of patients was analyzed,and logistic regression was used to analyze the influencing factors of delayed health-seeking behavior.Results From 2017 to 2022,33731 tuberculosis patients were registered in Wuhan,and the registered incidence rate of tuberculosis gradually decreased from 56.21/100000 in 2017 to 37.88/100000 in 2022,with an annual decline rate of 6.37%.The median time for tuberculosis patients to seek medical care was 11(3,27)days,and 16019(47.49%)of tuberculosis patients experienced delayed health-seeking behavior.From 2017 to 2022,the overall delayed health-seeking rate of pulmonary tuberculosis patients showed a downward trend,but the downward trend was not obvious(χ^(2)=0.142,P=0.706).Multivariate logistic regression analysis showed that the main influencing factors of delayed health-seeking behavior were older age(45-<60 years old group:OR=1.23,95%CI:1.04-1.46;≥60 years old group:OR=1.37,95%CI:1.15-1.63),living in remote urban areas(OR=1.27,95%CI:1.21-1.33),as well as patients with referral sources(OR=1.17,95%CI:1.05-1.30)and follow-up sources(OR=1.38,95%CI:1.24-1.55)as the source of healthseeking,while professions such as agricultural,forestry,animal husbandry,and fishery production personnel,other professions were protective factors for timely health-seeking(OR=0.52-0.70,95%CI:0.45-0.85).Conclusions The delayed health-seeking behavior of pulmonary tuberculosis patients in Wuhan is generally declining,but there is still considerable room for improveme

关 键 词：肺结核 就诊延迟 流行病学 回归分析 

分 类 号：R521[医药卫生—内科学]