关键词: 结核, 诊室就医, 就诊延迟, 诊断延迟

Abstract:

Objective To analyzed the visit behavior of pulmonary tuberculosis (PTB) patients in the areas where the project of “Exploring and improving the detection level of tuberculosis in underdeveloped areas” were implemented, to provide basis for formulating the detection measures of PTB patients in underdeveloped areas. Methods Data of 875 PTB cases, whose “current address” were Qingjian and Zizhou registered from 2017 to 2020, were collected from TB Management Information System. Of these cases, 441 were registered before the implementation of the project (January 1, 2017-December 31, 2018), and 434 were registered during the project (January 1, 2019-December 31, 2020). Information of patients from Infectious Disease Reporting Information System and TB Management Information System were matched using Excel 2016. The non-local diagnosis rate (NDR), delayed rate (PDR) of visit and delayed rate (DDR) of diagnosis before and during the implementation of project were analyzed. Results The NDR of PTB during the implementation of the project was significantly higher than that before the implementation of the project (84.10% (365/434) vs. 62.81% (277/441), χ ²=50.74, P=0.000). From 2017 to 2020, PDR was 48.34% (423/875) and DDR was 18.63% (163/875) in Qingjian and Zizhou. The PDR during the implementation of the project was significantly higher than that before the implementation of the project (52.76% (229/434) vs. 43.99% (194/441), χ ²=6.74, P=0.009); the DDR before the implementation of the project was significantly lower than that during the implementation (23.36% (103/441) vs. 13.82% (60/434), χ ²=13.11, P=0.000). DDR of PTB whose first visit were non-local before the implementation of the project was significantly higher than that during the significantly (33.94% (94/277) vs. 15.07% (55/365), χ ²=31.45, P=0.000). PDR of PTB whose first visit in Qingjian and Zizhou were significantly higher than before the implementation (73.91% (51/69) vs. 48.78% (80/164), χ ²=12.46, P=0.000). As to patients first diagnosed in designated hospitals, the DDR before the implementation of the project was significantly higher than that during the implementation (16.53% (60/363) vs. 7.58% (27/356), χ ²=13.52, P=0.000); in the other hospital, the PDR during the implementation of the project was significantly higher than before the implementation (32.05% (25/78) vs. 24.36% (19/78),χ ²=29.82, P=0.000). Conclusion During the implementation of the project, the NDR of PTB patients in underdeveloped areas increased, visit delay was not significantly improved, while diagnosis delay was improved. Comprehensive measures should be taken to improve visit behavior, graded diagnosis and treatment should be strengthened, and visit delay should be reduced.

Key words: Tuberculosis, Office visits, Patient delay, Diagnosis delay