2015~2019年太原市肺结核患者就诊延误情况及影响因素分析

Analysis on the situation and influencing factors of treatment delay of pulmonary tuberculosis patients, Taiyuan city,2015-2019

目的了解肺结核患者就诊延误情况及影响因素,为制定太原市结核病防控策略提供科学依据。方法从中国疾病预防控制信息系统的结核病管理信息中,收集2015~2019年登记的肺结核患者病案信息,采用单因素和多因素分析就诊延迟的影响因素。结果太原市2015~2019年肺患者就诊延迟率为67.41%,就诊天数中位数为27(10~60)d。<25岁组就诊延迟的比例由2015年19.82%减少到2019年的11.42%。女性、65~岁组、离退人员、因症推荐及有合并症的肺结核患者就诊延迟率较高,差异有统计学意义(P<0.05或<0.01)。多因素结果分析可知,以下特征的肺结核病患者更容易出现就诊延迟:25~、45~、65~岁组(相对<25岁组),OR值分别为1.20(1.00~1.44)、1.83(1.51~2.22)、1.73(1.37~2.18)(P<0.05或<0.01);患者来源为因症就诊、因症推荐、转诊、追踪的患者(相对于健康检查),OR值分别为3.86(2.74~5.44)、4.91(2.19~11.02)、3.45 (2.41~4.92)、4.75(3.36~6.73)(P<0.01)。结论 2015~2019年太原市肺结核患者就诊延误较为普遍。

Objective To understand the delay in treatment of pulmonary tuberculosis(PTB) patients and its influencing factors, so as to provide scientific basis for formulating tuberculosis prevention and control strategies in Taiyuan city. Methods Data of PTB cases registered during 2015-2019 were collected from TB management information of China Information System for Disease Control and Prevention.Influencing fators of PTB patient delay were analyzed by univariate and multivariate logistic regression. Results The delayed visit rate of lung patients in Taiyuan from 2015 to 2019 was 67.41%,and the median number of visit days was 27(10-60) d.The proportion of patients aged less than 25 years old decreased from 19.82% in 2015 to 11.42% in 2019.The delay rate of PTB was higher in females, aged ≥ 65,retired persons, recommended by diseases and patients with comorbidities(P<0.05 or <0.01).Multivariate Logistic regression analysis showed those with the following characteristics were more likely to delay in seeking health care: aged 25-,45-,and 65-(aged<25 as reference),OR=1.20(1.00-1.44),1.83(1.51-2.22),1.73(1.37-2.18),respectively(P<0.05 or<0.01),clinical consultation, recommendation, referral, and tracing(health check as reference),OR=3.86(2.74-5.44),4.91(2.19-11.02),3.45(2.41-4.92),4.75(3.36-6.73),respectively(P<0.01). Conclusion From 2015 to 2019,PTB in Taiyuan are commonly delayed in seeking health care.