农村贫困地区肺结核患者就诊延迟及其原因分析

Analysis on patient delay and reasons for pulmonary tuberculosis in poor rural

目的分析农村贫困地区肺结核患者就诊延迟,及供需双方因素对就诊延迟的影响,为提高病人发现提供参考。方法福建、河南、辽宁和新疆4省各3个经济欠发达县,定量与定性方法结合,调查就诊延迟及其影响因素。对象包括病人、医务人员和管理人员。以首发症状到就医的时间在14 d以上为就诊延迟。结果肺结核病人就诊延迟比例高,有33．6％的病人存在就诊延迟。综合分析供需方的因素:(1)农民群众普遍存在结核病知识的缺乏。(2)医疗服务供给方健康促进工作不够。结论我国农村贫困地区还普遍存在结核病就诊延迟的现象,应该通过有针对性地健康促进工作提高结核病知晓率,并采用多种方式改变就医行为。

Objective To further analyze the situation of patient delay and the impact factors from TB patients and health service providers in poor rural China, and to provide suggestions to increase TB case detection. Methods 3 poor counties in each of the four provinces, e.g. Fujian, Henan, Liaoning and Xinjiang were selected as study sites. Both quantitative and qualitative methods were applied to study the patient delay and its impact factors. The study targets included TB patients, health workers and administrators. Patient delay was defined as more than 2 weeks from first symptoms to first visit for doctors. Results Patient delay is rather common in TB patients, with 33.6 % TB patients delayed in seeking health care. The factors impacted delay from TB patients and health service providers include ： （ 1 ） Lack of TB knowledge is common among general population in rural area; （2）Health promotion activities conducted by health providers are not enough. Conclusion Patient delay is rather common in poor rural area in China. TB awareness should be improved by targeted health promotion activities. Integrated measures should be taken to change the health care seeking behaviors among the rural population.