广州市海珠区肺结核患者就诊延误影响因素的研究

伍小英; 钟小燕; 谭守勇; 张晋昕; 黄嘉玲; 宋嘉麒; 杜雨华; 张雅惠; 罗少霞

doi:10.16462/j.cnki.zhjbkz.2016.06.007

广州市海珠区肺结核患者就诊延误影响因素的研究

doi: 10.16462/j.cnki.zhjbkz.2016.06.007

1. 广州市胸科医院广州市结核病防治所结核科, 广东广州 510000;
2. 中山大学公共卫生学院医学统计与流行病学系, 广东广州 510080;
3. 广州市胸科医院结核科, 广东广州 510095 [作者介绍] 伍小英(1974- ), 女, 广东广州人, 副主任医师, 硕士。主要研究方向:结核病预防与控制。

基金项目:

广州市科技计划项目（2014Y2-00104）；广州市医药卫生科技一般引导项目（20131A011075）；广州市胸科医院科研基金项目（XK2013-011）

详细信息

中图分类号: R521;R181.2
计量
- 文章访问数: 436
- HTML全文浏览量: 78
- PDF下载量: 42
- 被引次数: 0
出版历程
- 收稿日期: 2016-01-08
- 修回日期: 2016-03-22

Factors associated with patients' delayed diagnosis of pulmonary tuberculosis in Haizhu District of Guangzhou City

1. Tuberculosis Departmet of Tubercosis Prevention and Control Institute, Guangzhou Chest Hospital, Guangzhou 510000, China;
2. Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
3. Tuberculosis Departmet of Guangzhou Chest Hospital, Guangzhou 510095, China

摘要

摘要: 目的分析广州市海珠区肺结核患者就诊延误情况及其影响因素，为制定减少就诊延误发生的干预措施提供科学依据。方法采取随机抽样调查方法，应用编制的问卷对2014年1月1日~2014年12月31日登记发现的150例广州市海珠区肺结核患者进行面对面的问卷调查，并收集患者病历资料，分别从基本情况、经济因素及临床因素分析就诊延误的影响因素。结果 150例肺结核患者就诊延误率为52.0%（78/150）。多因素分析结果表明转诊（OR=0.121，95% CI：0.028~0.513）、咯血（OR=0.291，95% CI：0.098~0.860）是减少就诊延误的因素；就诊交通费支出≥50 元/月（OR=7.334，95% CI：1.729~31.113）、因症就诊（OR=3.225，95% CI：1.337~7.775）是增加就诊延误的因素。结论广州市海珠区肺结核患者存在一定的就诊延误，提高人群结核病相关知识的知晓水平，加强转诊，改善结核病定点医疗机构服务的可及性和便利性，增强人群健康体检意识，从而减少肺结核患者就诊延误。
- 结核,肺 /
- 病人转诊 /
- 流行病学方法
Abstract: Objective To analyze the factors associated with patients' delayed diagnosis of pulmonary tuberculosis in Haizhu District of Guangzhou City and provide scientific intervention measures to avoid the delay. Methods The random sampling method was adopted. There were 150 cases diagnosed with pulmonary tuberculosis from January 1st, 2014 to December 31st, 2014. They were investigated by face-to-face questionnaire, and the basic medical information was collected. Influential factors of delayed diagnosis of pulmonary tuberculosis were explored from common information, economic situation and clinical status. Results The patients' delay rate in 150 cases of pulmonary tuberculosis was 52.0% (78/150). Multi-factor analysis showed that the referral (OR=0.121, 95% CI: 0.028-0.513) and hemoptysis (OR=0.291, 95% CI: 0.098-0.860) were beneficial factors for the delay. The transportation expenses over 50 Chinese Yuan per month (OR=7.334, 95% CI: 1.729-31.113) and the symptom-driven (OR=3.225, 95% CI: 1.337-7.775) were risk factors leading to the delay. Conclusions Patients' delay diagnosis is popular in pulmonary tuberculosis patients in Haizhu District of Guangzhou, and we should spread public knowledge on pulmonary tuberculosis to reduce the occurrence and improve the convenience and accessibility of certificated tuberculosis medical institution, it is important to strengthen public consciousness of regular physical examination.
- Tuberculosis, pulmonary /
- Patient transfer /
- Epidemiologic methods

HTML全文

参考文献(24)

World Health Organization. The global tuberculosis report 2015 [R]. Geneva, 2015.

Lin X, Chongsuvivatwong V, Lin L, et al. Dose-response relationship between treatment delay of smear-positive tuberculosis patients and intra-household transmission: a cross-sectional study [J]. Trans R Soc Trop Med Hyp, 2008,102(8):797-804.

马玙,朱莉贞,潘毓萱. 结核病学 [M]. 北京:人民卫生出版社, 2006:595-596.

中华医学会. 临床诊疗指南:结核病分册 [M]. 北京:人民卫生出版社, 2005:7-10.

钟球. 广东省结核病控制项目实施工作指南 [M]. 广州:广东省结核病控制项目办公室, 2008:1-83.

周成超,楚洁,耿红,等. 社会经济状况对流动人口肺结核病人就诊延迟影响研究 [J]. 中国卫生事业管理, 2011,(7):554-556.

全国第五次结核病流行病学抽样调查技术指导组,全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告 [J]. 中国防痨杂志, 2012,34 (8):485-508.

白丽琼,肖水源,李艳红,等. 发现延误对肺结核经济负担的影响 [J]. 中国防痨杂志, 2012,34(11): 697-703.

伍小英,谭守勇,罗少霞,等. 广州市2009-2013年肺结核流行状况分析 [J]. 广东医学, 35(21): 3400-3405.

徐松艳,刘爱萍. 北京市朝阳区肺结核患者就诊及确诊延误情况调查分析 [J]. 慢性病学杂志, 2013,14(10): 765-769.

Buregyeya E, Criel B, Nuwaha F, et al. Delays in diagnosis and treatment of pulmonary tuberculosis in Wakiso and Mukono districts, Uganda [J]. BMC Public Health. 2014,14:586.

Biya O, Gidado S, Abraham A, et al. Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010 [J]. Pan Afr Med J, 2014,18 Suppl 1:6.

Takarinda KC, Harries AD, Nyathi B, et al. Tuberculosis treatment delays and associated factors within the Zimbabwe national tuberculosis programme [J]. BMC Public Health, 2015,15:29.

Saifodine1 A, Samo Gudo PA, Sidat M, et al. Patient and health system delay among patients with pulmonary tuberculosis in Beira city, Mozambique [J]. BMC Public Health, 2013,13:559.

陈松华,王晓萌,钟节鸣,等. 肺结核病新患者发现延误及影响因素分析 [J]. 中国公共卫生, 2013,29(4): 481-484.

Belkina1 TV, Khojiev DS, Tillyashaykhov MN, et al. Delay in the diagnosis and treatment of pulmonary tuberculosis in Uzbekistan: a cross-sectional study [J]. BMC Infect Dis, 2014,14:624.

Gebeyehu E, Azage M, Abeje G. Factors Associated with Patient's Delay in Tuberculosis Treatment in Bahir Dar City administration, Northwest Ethiopia [J]. Biomed Res Int, 2014:701429.

Asefa A, Teshome W. Total delay in treatment among smear positive pulmonary tuberculosis patients in five primary health centers, southern Ethiopia: a cross sectional study [J]. PLoS One, 2014, 9(7) :e102884

赵秀秀,徐凌忠,郭振,等. 肺结核病人就诊延迟影响因素分析 [J]. 中国卫生事业管理, 2012, (10): 795-797.

段琼红,汪鹏,吕静,等. 肺结核可疑症状者结核病医疗服务可及性研究 [J]. 中华疾病控制杂志, 2013,17(6):530-532.

梁长威,赵亚玲,韦琪平. 南宁市贫困县初治涂阳肺结核患者诊断延误及其影响因素 [J]. 中国热带医学, 2012,12(7):794-797.

Alavi SM, Bakhtiyariniya P, Albagi A. Factors associated with delay in diagnosis and treatment of pulmonary tuberculosis [J].Jundishapur J Microbiol, 2015,8(3): e19238

路丽苹,洪建军,高谦,等. 上海松江2006-2011年新登记肺结核时空分布规律及影响因素 [J]. 中华疾病控制杂志, 2014,18(8):709-714

钟球. 结核病管理 [M]. 北京:人民卫生出版社, 2011:16-17.

施引文献

资源附件(0)

访问统计