2012-2022年宁波市某定点医院肺结核患者延迟就诊情况及影响因素分析

Analysis of Tuberculosis Patient Delay and Influencing Factors in a Designated Hospital in Ningbo from 2012 to 2022

目的分析宁波市某结核病定点医院2012-2022年间肺结核患者就诊延迟情况及其影响因素,为降低肺结核患者就诊延迟率以及强化防控措施提供科学依据。方法收集2012-2022年宁波市某结核病定点医院登记上报到“中国疾病预防控制系统结核病管理信息系统”的肺结核患者的病案信息(共17027例肺结核患者),利用χ^(2)趋势检验、χ^(2)检验和多因素Logistic回归分析模型对延迟就诊率的变化趋势及影响因素进行分析。结果2012-2022年,该医院肺结核延迟就诊率为54.37%。肺结核患者延迟就诊率的变化趋势为2012-2018年呈上升趋势(趋势χ^(2)=40.29,P<0.001),2019-2022年呈下降趋势(趋势χ^(2)=57.86,P<0.001)。肺结核患者就诊延迟单因素分析结果显示,不同性别、年龄、职业、患者来源和病原学结果的肺结核患者组间就诊延迟率差异均具有统计学意义。多因素Logistic回归分析模型结果显示,女性患者、年龄组为45~<65岁、≥65岁,职业为工人及其他公职人员、农牧民及民工、家务待业及离退休、水上作业及长途驾驶、商业服务及其他、患者来源为转诊和病原学阳性的肺结核患者发生延迟就诊风险更高。结论2019年以来,宁波市该定点医院肺结核患者延迟就诊率有所下降,但为了进一步减少肺结核延迟就诊现象,仍需针对高危因素采取更加有效的防控措施。

Objective To analyze the delay of treatment in pulmonary tuberculosis(TB)patients from 2012 to 2022 and its influencing factors,then provide scientific basis for reducing the delay rate of TB patients and strengthen the prevention and control measurements.Methods The medical record information of TB patients registered in the China CDC TB Management Information System from 2012 to 2022 was collected(there were 17027 cases of tuberculosis).Change trend and influencing factors of TB patient delayed were analyzed usingχ^(2)test,χ^(2)trend test and multivariate logistic regression analysis model.Results The delayed rate of TB patients for seeking health care was 54.37%in the designated hospital of Ningbo.The trend of TB patients delayed in seeking health care increased from 2012 to 2018(trendχ^(2)=40.29,P<0.001)and decreased from 2019 to 2022(trendχ^(2)=57.86,P<0.001).The results of univariate analysis of the delay showed difference between gender,age,occupation,patient origin and etiology results.Multivariate logistic regression analysis model analysis results showed that female patients,age group of 45~<65,≥65 years old,occupation for workers,farmers/herdsmen/migrant workers,housework/retired,water operations/long-distance driving,business services/other,patient source for referral and etiology positive TB patients had a higher risk of TB patients delayed in seeking health care.Conclusion Since 2019,the rate of delayed TB patients for seeking health care in the designated hospital of Ningbo has decreased.However,in order to reduce the phenomenon of patients delay,more effective prevention and control measures should be taken for high risk factors.