陕西省2015年肺结核患者就诊延迟及其相关因素分析

目的 了解陕西省肺结核患者就诊延迟现况,探索与就诊延迟相关的主要因素.方法 从结核病信息管理系统导出陕西省2015年登记的结核病患者个案资料19 319例.采用描述性统计方法,计算就诊延迟率;采用卡方检验分析不同地域、性别、年龄、民族、职业、治疗分类、患者来源、户籍类型的就诊延迟是否有差异,以P＜0.05为差异有统计学意义;采用logistic回归模型进行多因素分析,以P＜0.05为差异有统计学意义.结果 陕西省肺结核患者就诊延迟率为57.7％(11 152/19 319),就诊延迟中位数为19d.多因素Logistic回归分析结果表明:地域、性别、年龄、治疗分类和患者来源是就诊延迟的影响因素(P＜0.05).女性就诊延迟率是男性患者的1.095倍(OR=1.095,95％CI=1.030～1.164).复治患者就诊延迟率是初治患者的1.221倍(OR=1.221, 95％CI=1.051～1.420).结论 陕西省肺结核患者就诊延迟情况比较严重.应根据就诊延迟的高危人群制定相应措施,积极有效的开展预防干预工作.

Investigation on health seeking delay and relevant factors among pulmonary tuberculosis patients in Shaanxi

Objective To understand the present situation of health seeking delay and explore its relevant factors among pulmonary tuberculosis (TB) patients in Shaanxi Province.Methods The individual data of 19 319 pulmonary TB patients notified in Shaanxi Province in 2015 were collected from the National TB Recording and Reporting (R & R) System.The rate of patients' health seeking delay was calculated with the descriptive statistical method.Chi-square test was used to analyze the differences of patients' health seeking delay by region,gender,age,ethnic,occupation,treatment classification,source of the patients,type of TB,and household type.Logistic regression analysis was used to the multivariate analysis.Results The overall rate of health seeking delay of the pulmonary TB patients was 57.7％ (11 152/19 319) in Shaanxi Province,and the median of delay was 19 days.The delay was related to region,gender,age,treatment classification and source of the patients (P＜0.05).The rate of health seeking delay of the female patients was higher than that of the male (OR=1.095,95％CI=1.030-1.164).The rate of health seeking delay of the re-treatment patients was higher than that of the initial treatment patients (OR=1.221,95％CI=1.051-1.420).Conclusion The rate of health seeking delay among pulmonary TB patients was very high in Shaanxi Province.Therefore,the effective measures should be taken to improve the situation,especially in the high-risk population.