关键词: 结核, 肺, 预防卫生服务, 病人预约和时间安排, 延误诊断, 因素分析, 统计学

Abstract:

Objective To investigate the patient delay among tuberculosis patients in Ji,nan and analyze the influencing factors in order to provide data support for health decision-making.Methods In November 2018, Ji’nan Municipal Center for Disease Control and Prevention selected 3 counties from all 10 counties by stratified sampling, the eastern counties with high economic level county (Zhanqiu District), the western counties with moderate economic level (Pingyin County) and the southern counties with low economic level (Changqing District). A face-to-face questionnaire survey was conducted on 234 patients with tuberculosis who were diagnosed and managed in the county-level tuberculosis control institutions from January to June 2018, and the demographic data (gender, age, occupation, education level, marital status), incidence and patient delay and access to health services (from village clinic/community health service station, township health center/community health service center, county tuberculosis designated hospital and general hospital) information such as distance and time required, 234 questionnaires were collected, and 234 information was completed, with an effective rate of 100.0%. Chi-square test and multivariate logistic regression were used to analyze the factors affecting the delay time of the visit.Results The patient delay rate of pulmonary tuberculosis patients in Ji’nan was 33.8% (79/234). Patients were divided into a delayed group (79 patients, 33.8%) and a non-delayed group (155 patients, 66.2%) according to the delay criteria for patient delay (≥14days). Multivariate logistic regression analysis showed that high school (Wald χ ²=4.19, P=0.041, OR (95%CI)=0.16 (0.03-0.93)), college and above (Wald χ ²=6.67, P=0.010, OR (95%CI)=0.13 (0.03-0.61)), and distance from the clinic >0.5 km (Wald χ ²=15.63, P=0.000, OR (95%CI)=5.48 (2.37-12.69)) were the factors affecting the patient delay.Conclusion The educational level of high school and college and above are the influencing factors to reduce the rate of patient delay. The distance from the clinic >0.5 km is the factor that increases rate of patient delay.

Key words: Tuberculosis, pulmonary, Preventive health services, Appointments and schedules, Delayed diagnosis, Factor analysis, statistical