Abstract:
Objective To analyze the current status and influencing factors of healthcare-seeking delay among elderly patients with pulmonary tuberculosis in Nanchong City from 2020 to 2024.
Methods A total of 852 patients with pulmonary tuberculosis (registered current residence in Nanchong City, age of ≥60 years) from 2020 to 2024 were selected as the study subjects. Basic patient information and clinical details were collected. The distribution and changing trends of healthcare-seeking delay time and delay rate among patients were analyzed. Multivariate Logistic regression model was used to analyze the influencing factors of delayed medical treatment in patients with pulmonary tuberculosis.
Results The median treatment time for elderly patients with pulmonary tuberculosis was 30 (11, 76) days. From 2020 to 2024, among the 852 elderly patients with pulmonary tuberculosis, 496 (58.22%) experienced healthcare-seeking delay. The healthcare-seeking delay rates from 2020 to 2024 were 51.59% (81/157), 53.45% (93/174), 58.79% (107/182), 61.40% (105/171) and 65.48% (110/168), respectively, showing an overall upward trend (χtrend2 = 8.673, P=0.003). The healthcare-seeking delay rates among patients of different genders and age groups (60 to 69 years, 70 to 79 years, and 80 to 98 years) all increased with the years (P < 0.05). Multivariate Logistic regression analysis showed that retired personnel (OR=0.598, 95%CI, 0.429 to 0.833), other occupations (OR=0.613, 95%CI, 0.459 to 0.820), as well as the source of patients was health examination (OR=0.442, 95%CI, 0.262 to 0.746) and no etiological outcome (OR=0.561, 95%CI, 0.377 to 0.835) were independent protective factors for delayed medical visit. The source of patients was referral (OR=2.184, 95%CI, 1.436 to 3.322) and follow-up (OR=2.125, 95%CI, 1.414 to 3.195), as well as the diagnosis type was tuberculous pleurisy (OR=2.328, 95%CI, 1.570 to 3.452), positive etiology (OR=2.368, 95%CI, 1.420 to 3.949), and complications (OR=1.260, 95%CI, 0.734 to 0.915, P=0.013) were independent risk factors for delayed medical visit.
Conclusion The rate of healthcare-seeking delay among elderly patients with pulmonary tuberculosis in Nanchong City is high and shows an upward trend, which may be related to occupation type, patient source, diagnostic classification, and etiological results.