2017—2021年安徽省淮北市结核患者就诊延迟情况及影响因素

Delayed medical visit among tuberculosis patients and risk factors in Huaibei City,Anhui Province from 2017 to 2021

【目的】了解安徽省淮北市2017—2021年结核病患者就诊天数、就诊延迟率等基本情况,分析影响就诊延迟的危险因素,为科学防控结核病提供依据。【方法】利用结核病管理信息系统收集2017—2021年淮北市结核病确诊患者的病案信息,通过秩和检验及多重线性回归研究结核病患者就诊天数的相关影响因素,通过χ~2检验、卡方Cocharan-Mantel-Haensze趋势检验和logistic回归研究结核病患者就诊延迟率的相关影响因素。【结果】2017―2021年淮北市结核病患者就诊天数的中位数为22 d,结核病患者就诊延迟率为68.57%。就诊延迟率总体呈下降趋势(χ_(趋势)^(2)=17.342,P=0.002)。就诊天数的多重线性回归中,诊断结果病原学阳性、有合并症是就诊天数增加的危险因素。就诊延迟率logistic回归分析结果显示,≤24岁组(OR=0.596,95%CI:0.503~0.706,P<0.05)、25~岁组(OR=0.667,95%CI:0.559~0.796,P<0.05)、35~岁组(OR=0.762,95%CI:0.613~0.947,P<0.05)、45~岁组(OR=0.838,95%CI:0.711~0.987,P<0.05)就诊者较55~岁年龄组就诊者就诊延迟风险低;流动人口较本地人口就诊延迟风险低(OR=0.838,95%CI:0.732~0.960,P<0.05)。【结论】诊断结果病原学阳性、有合并症是就诊天数增加的危险因素。2017—2021年淮北市结核病就诊延迟率5年间呈现下降趋势,≥55岁、本地人口是就诊延迟的危险因素。

[Objective] To understand the situation about time interval between the onset and medical visit among tuberculosis patients in Huaibei City,Anhui Province from 2017 to 2021,and to determine the delayed medical visit and its risk factors,as to provide evidence for tuberculosis prevention and control.[Methods] Case information of confirmed tuberculosis patients in Huaibei City in 2017-2021 was collected from the tuberculosis management information system.Factors associated with time interval between the onset and medical visit were analyzed using rank sum test and multivariate linear regression.Furthermore,factors associated with the delayed medical visit were determined by Chi-square test,Chi-square Cocharan-Mantel-Haensze test and logistic regression.[Results] The median time interval between the onset of tuberculosis and medical visit were 22 days among the tuberculosis patients in Huaibei City from 2017-2021,and the proportion of delayed medical visit was 68.57%.There was an overall decreasing trend in the proportion of delayed medical visit over years (χ_(trend)^(2)=17.342,P=0.002).Using the multivariate linear regression,positive for Mycobacterium Tuberculosis in the pathogenic diagnosis,and presence of comorbidities were determined to be the risk factors associated with increased time interval between the onset and medical visit.Furthermore,logistic regression analysis showed that patients aged ≤24 years(OR=0.596,95%CI:0.503-0.706,P<0.05),25-years(OR=0.667,95%CI:0.559-0.796,P<0.05),35-years(OR=0.762,95%CI:0.613-0.947,P<0.05),and 45-54 years(OR=0.838,95%CI:0.711-0.987,P<0.05) had significantly lower risk of delayed medical visit than those aged ≥ 55 years old group.Regarding the household registration status,non-local residents had lower risk of delayed medical visit than local residents(OR=0.838,95%CI:0.732-0.960,P<0.05).[Conclusion] Positive for Mycobacterium tuberculosis in the pathogenic diagnosis,and presence of comorbidities were risk factors associated with increased time interval between the onset and medical visit.The proportion of delayed medical visit among tuberculosis patients in Huaibei City from 2017 to 2021 showed a decreasing trend over 5 years,and age ≥55 years old and local residents were risk factors associated with delayed medical visit.