Current Status Of Tuberculosis Control And The Influencing Factors Analysis About The Delay In The Patients Discovery Process Of Haiyuan County,ningxia

ObjectiveThrough the investigation of the medical behavior of tuberculosis(TB)patients in Haiyuan County,Ningxia,to understand the basic situation of TB patients,the status of TB control and the delay in the discovery process of TB patients in Haiyuan County,to analyze the impact of its delay factors,to provide scientific theoretical basis and suggestions for the prevention and control of tuberculosis in Ningxia.MethodsTo investigate all TB patients after diagnosed and standard treated,from July 1,2012 to June 30,2013 in Haiyuan County,through face-to-face on-site.Combined with the first visit registration book of TB patients in Haiyuan County and the referral registration book of TB patients suspected in Haiyuan county to get baseline data of TB patients.The quantitative data were analyzed by means of mean,standard deviation,median and quartile range.Qualitative data was analyzed by using constituent ratio.Chi-square test and unconditional logistic regression were used to analyze the causes of delay of tuberculosis patients by single factor analysis and multiple factor analysis(a=0.05).Results1.There are 217 tuberculosis patients have been investigated of Haiyuan County,including 107 men and 110 women.Patients mean age is 56.5±19.2 years old.The proportion of Han and Hui is 1 to 4.7.The education level is mainly based on illiteracy and the occupation is mainly farmers.2.When they appeared tuberculosis symptoms,31.8% of the patients did not see a doctor immediately.Only 34.1% of patients have the ability to pay the part of their medical expenses during TB treatment.During tuberculosis,Up to 62.2% of patients have been to borrow money for the treatment of tuberculosis.During treatment,only 56.2% of TB patients take their medicine without other people’s supervision.69.6% of TB patients indicate medical staff have been visited their home,during treatment.At the end of treatment,41.5% of patients show that the doctor did not tell them whether the tuberculosis had been treated well or not.Only 13.8% of people had known tuberculosis knowledge before they had tuberculosis.The patients’ satisfaction with the convenience of hospital visiting process is 78.8% and the patients’ satisfaction with the tuberculosis-related knowledge introduced by doctor is 77.0%.The patients’ satisfaction with the tuberculosis visiting environment is 86.2% and the patients’ satisfaction with the medical insurance subsidy policy is 60.8%.3.Patient treatment delay rate is 57.1%.The median delay is 51.5 days and the quartile range is 94.0 days.Patient referral delay rate is 23.6%.The median delay is 23.0 days and quartile range is 40.0 days.The diagnosis delayed rate is 38.7%.The median delay is 45.0 days and the quartile range is 69.2 days.The discovery delay rate is 53.9%.The median delay is 79.0 days and the quartile range is 13.0 days.4.Patients with different educational levels,occupations and different measures of TB symptoms are found to have a statistically significant difference with treatment delay(P<0.05).The educational level and the measures for the occurrence of tuberculosis symptoms are the influencing factors of patients’ delay in treatment(P<0.05).The distance from the township hospital and the first time the medical institutions of patients with tuberculosis in different patients,which the difference of the referral delay is statistically significant(P<0.05).The distance from the residence to the township hospitals and the medical institutions for the first time are the influencing factors of the referral delay(P<0.05).Patients with different Age,education level,the distance from the county anti TB institutions,the distance from the residence to the township hospitals,medical institutions for the first time,the difference of diagnosis delay is statistically significant(P<0.05).Total cost of tuberculosis treatment,distance from the county anti TB institutions,distance from the township hospital and first visit medical institutions are the influencing factors of diagnosis delay(P<0.05).Patients with different medical institutions for the first time,the difference of discovery delay is statistically significant(P<0.05).The first visit medical institutions is the influencing factor of discovery delay(P<0.05).Conclusion1.Tuberculosis patients with low educational level and low awareness rate of tuberculosis knowledge,health awareness is not strong and the way of accepting tuberculosis knowledge is more passive.Patients with low income and low satisfaction of Medicare subsidy policy,they still have a heavy burden of disease.Many TB patients are still passive medication and medication compliance is not high.2.Delay in the discovery process of TB patients is not optimistic.3.There is significant difference of treatment delay between the TB patients with different occupations.Patients with low education level and who with TB symptoms did not immediately go to the medical institutions are more likely to have treatment delay.4.TB Patients with the farther distance from home to township hospital and the first visit is below the county level hospital are more likely to have referral delay.5.There are significant difference of diagnosis delay between the TB patients with different age and education.Patients with the less TB treatment costs,the distance from the township hospital farther,far from the county anti TB institutions and first visit is below the county level hospital are more likely to have diagnosis delay.6.TB Patients who first visit are below the county level hospital are more likely to have discovery delay.