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结核与肺部疾病杂志 ›› 2025, Vol. 6 ›› Issue (5): 558-565.doi: 10.19983/j.issn.2096-8493.20250058

• 论著 • 上一篇    下一篇

2018—2024年重庆市梁平区肺结核患者就诊延迟的变化趋势及影响因素分析

赵静1, 廖影1, 庞艳2, 王蕾3,4, 涂龙成1, 游茂林1, 何高琴1()   

  1. 1重庆市梁平区疾病预防控制中心疾病预防控制科, 重庆 405200
    2重庆市结核病防治所区县科, 重庆 400050
    3新疆医科大学公共卫生学院流行病与卫生统计学教研室, 乌鲁木齐 830000
    4新疆医科大学医学工程技术学院数学教研室, 乌鲁木齐 830000
  • 收稿日期:2025-04-01 出版日期:2025-10-20 发布日期:2025-10-15
  • 通信作者: 何高琴 E-mail:1054125651@qq.com
  • 作者简介:注:廖影与赵静对本研究具有同等贡献,为并列第一作者
  • 基金资助:
    国家自然科学基金(12061079);重庆市科卫联合医学科研项目(2024MSXM140);重庆市梁平区-璧山区协作科研项目(BSKJ2023068)

Analysis of the changing trend and influencing factors of healthcare-seeking delays among pulmonary tuberculosis patients in Liangping District, Chongqing from 2018 to 2024

Zhao Jing1, Liao Ying1, Pang Yan2, Wang Lei3,4, Tu Longcheng1, You Maolin1, He Gaoqin1()   

  1. 1Department of Disease Control and Prevention, Liangping District Center for Disease Control and Prevention, Chongqing 405200, China
    2Departments of District and County, Chongqing Tuberculosis Prevention and Control Institute, Chongqing 400050, China
    3Department of Epidemiology and Statistics, School of Public Health, Xinjiang Medical University, Urumqi 830000, China
    4Department of Mathematics, College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830000, China
  • Received:2025-04-01 Online:2025-10-20 Published:2025-10-15
  • Contact: He Gaoqin E-mail:1054125651@qq.com
  • Supported by:
    National Natural Science Foundation of China(12061079);Chongqing Science and Health Joint Medical Research Project(2024MSXM140);Chongqing Liangping District-Bishan District Collaborative Research Project(BSKJ2023068)

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摘要：

目的: 分析2018—2024年重庆市梁平区肺结核患者就诊延迟的变化趋势及影响因素,为优化肺结核综合防控措施提供参考。方法: 从“中国疾病预防控制信息系统”的“监测报告管理”模块中收集2018—2024年重庆市梁平区符合纳入条件的1751例肺结核患者病案信息,描述就诊延迟分布情况,使用年度变化百分比(annual percentage change,APC)、平均年度变化百分比(average annual percentage change,AAPC)和多因素logistic回归模型分析就诊延迟的变化趋势和影响因素。结果: 2018—2024年梁平区肺结核患者就诊延迟率为62.76%(1099/1751),就诊延迟天数中位数(四分位数)[M(Q1,Q3)]为31(16, 87)d;全人群、男性、女性、45~64岁组、65~96岁组、城区、乡镇各人群的就诊延迟率分别从2018年的80.65%(275/341)、78.91%(217/275)、87.88%(58/66)、83.85%(135/161)、84.62%(66/78)、84.09%(74/88)、79.45%(201/253),下降至2024年的60.59%(123/203)、60.36%(102/169)、61.76%(21/34)、65.38%(68/104)、61.02%(36/59)、65.33%(49/75)、57.81%(74/128),总体均呈下降趋势(AAPC分别为-5.723%、-5.057%、-8.083%、-5.036%、-5.751%、-5.949%、-5.773%,P值均<0.05)。多因素logistic分析结果显示,45~64岁年龄组、65~96岁年龄组、直接就诊/推介、转诊、追踪、其他患者来源发生就诊延迟的风险均较高[OR(95%CI)值分别为2.414(1.440~4.046)、2.280(1.321~3.935)、2.983(1.067~8.339)、2.871(1.045~7.888)、6.010(1.805~20.018)、12.584(1.279~123.806)]。结论: 2018—2024年梁平区肺结核患者就诊延迟率处于较高水平,但总体呈下降趋势,需针对危险因素和重点人群采取相应干预措施,改善就诊延迟情况。

关键词: 结核,肺, 就诊延迟, 因素分析, 传染病控制

Abstract:

Objective: To analyze the changing trend and influencing factors of healthcare-seeking delays among pulmonary tuberculosis (PTB) patients in Liangping District of Chongqing from 2018 to 2024, and to provide a reference for optimizing comprehensive PTB prevention and control measures. Methods: Medical records of 1751 eligible PTB patients in Liangping District of Chongqing from 2018 to 2024 were collected from the “Surveillance, Report and Management” subsystem of “China Disease Prevention and Control Information System”. The distribution of healthcare-seeking delays was described. The annual percentage change (APC), average annual percentage change (AAPC), and multivariate logistic regression models were used to analyze the trend and influencing factors of healthcare-seeking delay. Results: The healthcare-seeking delay rate among PTB patients in Liangping District during 2018—2024 was 62.76% (1099/1751), with a median delay duration (interquartile range) (M(Q1,Q3)) of 31 (16, 87) days. The healthcare-seeking delay rates for the entire population, males, females, the 45-64 age group, the 65-96 age group, urban areas, and rural townships decreased from 80.65% (275/341), 78.91% (217/275), 87.88% (58/66), 83.85% (135/161), 84.62% (66/78), 84.09% (74/88), and 79.45% (201/253) in 2018, respectively, to 60.59% (123/203), 60.36% (102/169), 61.76% (21/34), 65.38% (68/104), 61.02% (36/59), 65.33% (49/75), and 57.81% (74/128) in 2024. Overall, all groups showed a declining trend, with AAPCs of -5.723%, -5.057%, -8.083%, -5.036%, -5.751%, -5.949%, and -5.773%, respectively (all P<0.05). Multivariable analysis revealed that the 45-64 age group, the ≥65 age group, and patients whose source was categorized as “direct visit/referral”, “referral”, “tracking”, or “other” had a higher risk of healthcare-seeking delay (OR (95%CI): 2.414 (1.440-4.046), 2.280 (1.321-3.935), 2.983 (1.067-8.339), 2.871 (1.045-7.888), 6.010 (1.805-20.018), 12.584 (1.279-123.806), respectively). Conclusion: Although the healthcare-seeking delay rate among PTB patients in Liangping District remained high, but showed an overall downward trend. Targeted interventions addressing the identified risk factors and key populations are necessary to improve the situation of healthcare-seeking delays.

Key words: Tuberculosis, pulmonary, Healthcare-seeking delay, Factor analysis, Communicable disease control

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