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

  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.