青海省2014-2019年肺结核患者就诊延迟情况及影响因素

梁达; 商越; 王兆芬; 马斌忠

doi:10.16462/j.cnki.zhjbkz.2021.07.005

青海省2014-2019年肺结核患者就诊延迟情况及影响因素

doi: 10.16462/j.cnki.zhjbkz.2021.07.005

梁达¹,
商越¹,
王兆芬¹,
马斌忠^{1, 2, ,}

1.
810001 西宁，青海大学医学院公共卫生系
2.
810007 西宁，青海省疾病预防控制中心传染病防治所

基金项目:

国家自然科学基金 81860593

青海省高端创新人才千人计划项目 2017-2

详细信息

通讯作者:
马斌忠，E-mail: qhxnmbz@126.com

中图分类号: R521
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出版历程
- 收稿日期: 2020-06-16
- 修回日期: 2020-12-16
- 刊出日期: 2021-07-10

Analysis of the health-care seeking delay and influencing factors among pulmonary tuberculosis patients in Qinghai Province, 2014-2019

1.
Department of Public Health, Medical College, Qinghai University, Xining 810001, China
2.
Institute for Prevention and Control of Infectious Diseases, Qinghai Center for Disease Control and Prevention, Xining 810007, China

Funds:

National Natural Science Foundations of China 81860593

Qinghai Provincial thousand talents program for high-level innovative talents 2017-2

More Information

Corresponding author: MA Bin-zhong, E-mail: qhxnmbz@126.com

摘要

摘要: 目的分析青海省2014-2019年肺结核患者就诊延迟的现状、变化趋势以及影响因素。方法对青海省2014-2019年肺结核患者就诊延迟现状及变化趋势进行描述，并采用多因素Logistic回归分析模型分析肺结核患者就诊延迟影响因素。结果青海省2014-2019年肺结核患者就诊延迟率为49.6%，并呈现逐年下降趋势，且不同性别和年龄组患者就诊延迟率也均呈下降趋势；多因素Logistic回归分析模型分析结果显示，≥15岁年龄组、患者来源中的因症推荐、追踪和治疗分类中的复治是发生就诊延迟的高风险患者。非农民职业患者发生就诊延迟风险低于农民患者。结论青海省2014-2019年肺结核患者就诊延迟率较高，呈现下降趋势。年龄、职业、患者来源和治疗分类是肺结核患者就诊延迟的影响因素，应加强关注发生就诊延迟高风险患者。
- 肺结核 /
- 就诊延迟 /
- 影响因素
Abstract: Objective To analyze the current status, trend and related influencing factors of pulmonary tuberculosis patients with delayed health-care seeking in Qinghai Province from 2014 to 2019. Methods The current status and trend of health-care seeking delay of pulmonary tuberculosis patients in Qinghai Province from 2014 to 2019 were described, and multivariate Logistic regression model was used to analyze the related influencing factors of health-care seeking delay of pulmonary tuberculosis patients. Results The health-care seeking delay rate of pulmonary tuberculosis patients was 49.6%, showing a downward trend from 2014 to 2019. And the health-care seeking delayrate among different genders and age groups patients also showed a downward trend in Qinghai Province from 2014 to 2019. Multivariate Logistic regression analysis showed that the age group ≥15 years old, recommended by disease, follow-up and retreatment were high risk factors for patients of health-care seeking delay. The risk of health-care seeking delay of non-farmer patients was lower than farmer patients. Conclusion From 2014 to 2019, the health-care seeking delay rate of pulmonary tuberculosis patients in Qinghai Province was relatively high, but with an annual decrease. Age, occupation, source of patients and treatment classification were the influencing factors on health-care seeking delay of pulmonary tuberculosis patients. In the future, we should pay more attention to patients at high risk for health-care seeking delay.
- Pulmonary tuberculosis /
- Health-care seeking delay /
- Influencing factors

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图 1 青海省2014-2019年不同性别、年龄组肺结核患者就诊延迟率变化趋势

注：A不同性别就诊延迟率变化趋势；B不同年龄组就诊延迟率变化趋势。

Figure 1. Trend of health-care seeking delay rate of pulmonary tuberculosis patients among different genders and age groups in Qinghai Province from 2014 to 2019

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表 1 青海省2014-2019年肺结核患者就诊延迟现状及影响因素

Table 1. The current status and influencing factors of health-care seeking delay among pulmonary tuberculosis patients in Qinghai Province from 2014 to 2019

变量	总病例数(例)	就诊天数(d)[M(P₂₅, P₇₅)]	就诊延迟病例数(例)	就诊延迟率(%)	单因素分析^a		多因素分析^b
变量	总病例数(例)	就诊天数(d)[M(P₂₅, P₇₅)]	就诊延迟病例数(例)	就诊延迟率(%)	χ²值	P值	OR(95% CI)值	P值
时间(年)					298.80	< 0.001
2014-2016	8 397	18(5, 45)	4 793	57.1
2017-2019	14 182	18(5, 45)	6 406	45.2
性别					1.55	0.213
男	12 327	18(5, 45)	6 067	49.2
女	10 252	18(5, 45)	5 132	50.1
年龄组(岁)					55.90	< 0.001
0~＜15	671	17(5, 42)	250	37.3			1.00
15~＜55	14 421	18(5, 45)	7 077	49.1			1.51(1.29~1.78)	< 0.001
≥55	7 487	23(8, 52)	3 872	51.7			1.56(1.32~1.86)	< 0.001
民族					12.93	< 0.001
汉	7 161	18(5, 45)	3 678	51.4			1.00
其他	15 418	18(5, 45)	7 521	48.8			1.02(0.95~1.08)	0.600
职业					69.40	< 0.001
农民	10 539	18(5, 45)	5 540	52.6			1.00
非农民	12 040	18(5, 45)	5 659	47.0			0.82(0.77~0.87)	< 0.001
患者来源					89.64	< 0.001
因症就诊	14 006	18(5, 45)	6 713	47.9			1.00
因症推荐	529	18(5, 45)	303	57.3			1.39(1.17~1.66)	< 0.001
转诊	4 083	18(5, 45)	2 006	49.1			0.95(0.88~1.02)	0.162
追踪	3 625	18(5, 45)	2 027	55.9			1.34(1.25~1.45)	< 0.001
其他	336	18(5, 44)	150	44.6			0.90(0.72~1.12)	0.340
治疗分类					10.64	0.001
初治	21 648	18(5, 45)	10 688	49.4			1.00
复治	931	18(5, 45)	511	54.9			1.27(1.12~1.45)	< 0.001
合计	22 579	18(5, 45)	11 199	49.6
注：^a单因素χ²检验分析；^b多因素Logistic回归分析模型分析。

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