关键词: 结核,肺, 就诊延迟, 因素分析,统计学

Abstract:

Objective: To analyze the trend and associated factors of patient delay among pulmonary tuberculosis (PTB) patients in Yunnan Province from 2005 to 2024, evaluate tuberculosis prevention and control effectiveness, and provide evidence for reducing patient delay. Methods: Medical records of PTB patients registered in Yunnan Province in 2005, 2010, 2015, 2020, and 2024 were extracted from the Tuberculosis Management Information System, a subsystem of the China Disease Prevention and Control Information System. The patient delay rates and delay intervals of the five time points were analyzed to describe changes over the 20-year period. Multivariable logistic regression was used to identify factors associated with patient delay. Results: The patient delay rate in Yunnan Province decreased from 80.59% (13060/16205) in 2005 to 66.86% (12853/19223) in 2024, and the median delay interval declined from 53 (Q₁=21, Q₃=121) days to 25 (Q₁=11, Q₃=52) days, both showing significant downward trend (${\chi }_{trend}^{2}$=2117.178, P<0.001; J-T statistic=-67.150, P<0.001). Multivariable logistic regression revealed that patients aged <65 years (OR=1.120, 95%CI: 1.079-1.162), detected by passive case finding (OR=1.400, 95%CI: 1.328-1.475), from high-epidemic areas (OR=1.574, 95%CI: 1.526-1.623), being Han ethnicity (OR=1.270, 95%CI: 1.234-1.307), farmers (OR=1.817, 95%CI: 1.719-1.920), bacteriologically positive (OR=1.245, 95%CI: 1.211-1.279), local residents (OR=1.169, 95%CI: 1.114-1.228), and non-key populations (OR=1.273, 95%CI: 1.199-1.352) had higher risk of patient delay. Conclusion: Although the overall status of patient delay among PTB patients in Yunnan Province improved from 2005 to 2024, patients who were aged <65 years, Han ethnicity, farmers, local residents, from high-epidemic areas, and non-key populations still faced higher risks of delay.

Key words: Tuberculosis, pulmonary, Patient delay, Factor analysis, statistical