杨超, 王晶, 唐桂林. 2012-2021年北京市通州区流动人口肺结核患者就诊延迟的变化趋势及影响因素分析[J]. 疾病监测, 2023, 38(9): 1033-1038. DOI: 10.3784/jbjc.202303300140
引用本文: 杨超, 王晶, 唐桂林. 2012-2021年北京市通州区流动人口肺结核患者就诊延迟的变化趋势及影响因素分析[J]. 疾病监测, 2023, 38(9): 1033-1038. DOI: 10.3784/jbjc.202303300140
Yang Chao, Wang Jing, Tang Guilin. Analysis on trend of medical care seeking delay in pulmonary tuberculosis patients in floating population and influencing factors in Tongzhou district of Beijing, 2012−2021[J]. Disease Surveillance, 2023, 38(9): 1033-1038. DOI: 10.3784/jbjc.202303300140
Citation: Yang Chao, Wang Jing, Tang Guilin. Analysis on trend of medical care seeking delay in pulmonary tuberculosis patients in floating population and influencing factors in Tongzhou district of Beijing, 2012−2021[J]. Disease Surveillance, 2023, 38(9): 1033-1038. DOI: 10.3784/jbjc.202303300140

2012-2021年北京市通州区流动人口肺结核患者就诊延迟的变化趋势及影响因素分析

Analysis on trend of medical care seeking delay in pulmonary tuberculosis patients in floating population and influencing factors in Tongzhou district of Beijing, 2012−2021

  • 摘要:
      目的  分析2012—2021年北京市通州区流动人口肺结核患者就诊延迟情况及影响因素,为有效减少流动人口肺结核患者就诊延迟提供科学依据。
      方法  通过“中国疾病预防控制信息系统”的子系统“结核病信息管理系统”收集北京市通州区2012—2021年流动人口肺结核患者病案信息,包括患者的性别、年龄、民族、职业、患者来源、病原学结果、治疗分类、并发症、现住址、症状出现日期、首次就诊日期、登记日期等,描述就诊延迟分布情况及变化趋势。 采用单因素χ2检验和多因素logistic回归分析患者就诊延迟的影响因素。
      结果  2012—2021年北京市通州区共登记3202例流动人口肺结核患者,男女性别比为1.75∶1,年龄以15~44岁中青年为主[79.17%(2535/3202)],就诊天数中位数(四分位数)为7(0,32)d,平均就诊延迟率38.63%(1237/3202)。 就诊天数中位数由2012年的10 d下降至2021年的2 d,总体呈下降趋势。 就诊延迟率由2012年的43.33%(91/210)下降至2021年的33.07%(126/381),总体呈下降趋势(趋势χ2=8.933,P=0.003)。 就诊延迟患者中以男性为主62.33%(771/1237),25~44岁组构成比最高54.49%(674/1237),10年间不同年龄组间就诊延迟构成比差异有统计学意义(趋势χ2=21.644,P<0.001)。 多因素logistic回归分析显示:职业不详[比值比(OR)=2.351,95%置信区间(CI):1.282~4.312]和复治(OR=1.457,95%CI:1.024~2.075)均为就诊延迟的危险因素。 少数民族(OR=0.662,95%CI:0.515~0.85)、公共场所/商业服务(OR=0.529,95%CI:0.385~0.726)、病原学阴性/未查OR=0.637,95%CI:0.547~0.742)和登记日期为2020—2021年(OR=0.650,95%CI:0.539~0.784)均为就诊延迟的保护因素。
      结论  北京市通州区流动人口肺结核患者就诊延迟总体呈下降趋势,就诊延迟与患者民族、职业、病原学结果、治疗分类和登记日期有关,应针对其实施有针对性的干预策略。

     

    Abstract:
      Objective  To analyze the medical care seeking delay in pulmonary tuberculosis (TB) patients in floating population and influencing factors in Tongzhou district of Beijing, and provide scientific evidence for reducing the medical care seeking delay in pulmonary TB patients, 2012−2021.
      Methods  The information of pulmonary TB patients in floating population in Tongzhou from 2012 to 2021, including gender, age, ethnicity, occupation, case source, the result of etiological examination, treatment classification, complication, current address, onset date of, the date of the first medical case seeking and the date of registration, were collected from Tuberculosis Management Information Sub-system of China Information System for Disease Control and Prevention to analyze the distribution and trend of the medical care seeking delay. Univariate χ2 test and multivariate Logistic regression analysis were conducted to identify the influencing factors.
      Results  From 2012 to 2021, a total of 3202 cases of pulmonary TB patients in floating population were registered in Tongzhou. The male to female ratio of the patients was 1.75∶1. The patients were mainly aged 15–44 years (79.17%, 2535/3202). The median quartile of medical care seeking delay was 7 days (0, 32). The average medical care seeking delay rate was 38.63% (1237/3202). The median of health care seeking delay ranged from 10 days in 2012 to 2 days in 2021, showing a downward trend. The medical care seeking delay rate decreased from 43.33% (91/210) in 2012 to 33.07% (126/381) in 2021 (trend χ2 =8.933, P=0.003). The majority of the patients with medical care seeking delay were men (62.33%, 771/1237). The composition ratio of the patients aged 25–44 years was highest (54.49%, 674/1237), the differences were significant among different age groups (trend χ2=21.644, P<0.001). Multivariate Logistic regression analysis showed that unknown occupation odds ratio (OR) =2.351, 95% confidence interval (CI): 1.282–4.312] and re-treatment (OR=1.457, 95%CI: 1.024–2.075) were risk factors for medical carte seeking delay. Being in minority ethnic group (OR=0.662, 95%CI: 0.515–0.85), being engaged in public/business service (OR=0.529, 95%CI: 0.385–0.726), being negative in etiological examination/unexamined (OR=0.637, 95%CI: 0.547–0.742) and being registered during 2020−2021 (OR=0.650, 95%CI: 0.539–0.784) were protective factors for medical care seeking delay.
      Conclusion  The medical care seeking delay rate in pulmonary TB patients in floating population in Tongzhou showed a downward trend. The medical care seeking delay was related to ethnicity, occupation, the result of etiological examination, treatment classification and date of registration. It is necessary to take targeted intervention measures.

     

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