北京市顺义区肿瘤患者社区随访失访与就诊现状分析

Analysis of Community Follow-up and Medical Treatment of Cancer Patients in Shunyi District, Beijing

目的了解本地区户籍肿瘤患者失访的影响因素和就诊现状,为肿瘤防治提供科学信息。方法从全市二级及以上门诊系统提取2014-2017年确诊的、现住址为北京市的肿瘤患者信息,与死因登记系统、北京肿瘤医院随访系统及北京市卫生健康委信息中心门诊数据库进行匹配,去除已经死亡的和近期随访过的患者,以电话、村居委会、健康档案为等方式,向患者本人或家属调查患者生存状态。结果本地区肿瘤患者1260例,其中男性487例,女性773例,发病年龄在0~90岁,平均发病年龄(58.23±13.58)岁,本次成功随访1195例,失访65例,失访率5.15%,随访方式以电话、村/居委会随访方式为主;不同随访年龄、不同发病年龄、顺义河东与河西地区的失访率比较,差异有统计学意义(P<0.05);男性在区外医疗机构、三级医疗机构就诊的比例高于女性,差异有统计学意义(P<0.05);河西地区的患者区外医疗机构、三级医疗机构就诊比例高于河东地区,差异有统计学意义(P<0.05)。结论影响顺义区2020年户籍患者肿瘤随访失访率的因素主要包括患者随访时年龄、患者发病年龄、现住址所在地区等,其中不同性别、不同地区的患者选择就诊医疗机构有所不同。

Objective To understand the influencing factors and treatment status of patients with registered tumor in the region,and to provide scientific information for tumor prevention and treatment.Methods The information of cancer patients diagnosed in Beijing from 2014 to 2017 was extracted from the secondary and above outpatient system of the city,and matched with the death registration system,the follow-up system of Beijing Cancer Hospital and the outpatient database of the Information Center of Beijing Health Commission.The patients who had died and had recently been followed up were removed.The survival status of the patients was investigated by telephone,village committee and health records.Results There were 1260 cases of tumor patients in this area,including 487 males and 773 females.The age of onset was from 0 to 90 years old,and the average age of onset was(58.23±13.58)years old.The successful follow-up was 1195 cases,65 cases were lost,and the loss rate was 5.15%.The follow-up methods were mainly telephone and village/neighborhood committee follow-up.There were statistically significant differences in the lost follow-up rates among different follow-up ages,different onset ages,and Shunyi Hedong and Hexi areas(P<0.05).The proportion of males visiting medical institutions outside the district and tertiary medical institutions was higher than that of females,and the difference was statistically significant(P<0.05).The proportion of medical institutions outside the district and tertiary medical institutions in Hexi area was higher than that in Hedong area,and the difference was statistically significant(P<0.05).Conclusion The factors that affect the follow-up rate of cancer patients in registered residence in Shunyi District in 2020 are age at the time of follow-up,the age of onset of the patients,and the area where the current address is located.Among them,patients with different genders and regions choose different medical institutions.