Sun Xiaoyan, Luo Shuying, Lou Lingqiao, Cheng Hang, Ye Zhen, Jia Jianwei, Wei Yina, Tao Jingbo, He Hanqing
Yiwu Center for Disease Control and Prevention, Yiwu, 322000, P.R. China.
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, P.R. China.
BMC Public Health. 2021 Jun 16;21(1):1157. doi: 10.1186/s12889-021-11250-5.
Previous studies have shown that a certain proportion of the population did not seek medical treatment after coughing, and understanding the potential reasons is crucial for disease prevention and control.
A population-based study was conducted with the probability proportional to population size sampling in Yiwu, Zhejiang, China. A total of 5855 individuals aged ≥15 years lived in Yiwu for more than 6 months were included. All participants completed a laptop-based questionnaire to collect detailed information by a face-to-face interview. Characteristics of individuals were described by categories of health seeking behavior using frequency and percentage. Univariate and multivariate logistic regression analyses were performed to estimate the associations of social-demographic and cough characteristics with health seeking behavior.
19.3% (1129/5855) of participants had a cough in the past month, 40% (452/1129) had sought medical treatment. Of these, 26.5% (120/452) chose hospitals at county level or above. Individuals aged ≥65 years old (OR = 2.25, 95% CI: 1.23, 4.12), female (OR = 1.57, 95% CI: 1.21, 2.06), living in rural areas (OR = 1.30, 95% CI: 1.003, 1.69), persistent cough for 3-8 weeks (OR = 2.91, 95% CI: 1.72, 4.92) and with more accompanying symptoms (P < 0.001) were more likely to seek medical treatment, but those coughed for > 8 weeks were not (p > 0.5). Female (OR = 0.33, 95% CI: 0.21, 0.54) and people living in rural areas (OR = 0.57, 95% CI: 0.36, 0.92) were less likely to choose hospitals at county level or above while the higher educated were more likely to (OR = 3.29, 95% CI: 1.35, 8.02). Those who coughed for more than 2 weeks were more likely to choose hospitals at or above the county level. But the number of accompanying symptoms does not show any significant relationship with the choice of medical facility.
The present study found that age, sex, living areas and features of cough were associated with health seeking behavior. It is worth noting that those who coughed for too long (e.g. > 8 weeks) were less likely to seek medical treatment. Targeted measures should be developed based on the key factors found in this study to guide persons to seek medical treatment more scientifically.
以往研究表明，一定比例的人群咳嗽后未就医，了解其潜在原因对疾病防控至关重要。
在中国浙江义乌进行了一项基于人群的研究，采用与人口规模成比例的概率抽样方法。共纳入5855名年龄≥15岁、在义乌居住超过6个月的个体。所有参与者通过面对面访谈完成一份基于笔记本电脑的问卷，以收集详细信息。采用频率和百分比按就医行为类别描述个体特征。进行单因素和多因素逻辑回归分析，以评估社会人口学特征和咳嗽特征与就医行为的关联。
19.3%（1129/5855）的参与者在过去一个月内有咳嗽症状，其中40%（452/1129）寻求了医疗治疗。在这些寻求治疗的人中，26.5%（120/452）选择了县级及以上医院。年龄≥65岁的个体（OR = 2.25，95%CI：1.23，4.12）、女性（OR = 1.57，95%CI：1.21，2.06）、居住在农村地区的个体（OR = 1.30，95%CI：1.003，1.69）、咳嗽持续3 - 8周的个体（OR = 2.91，95%CI：1.72，4.92）以及伴有更多伴随症状的个体（P < 0.001）更有可能寻求医疗治疗，但咳嗽超过8周的个体则不然（P > 0.5）。女性（OR = 0.33，95%CI：0.21，0.54）和居住在农村地区的个体（OR = 0.57，95%CI：0.36，0.92）选择县级及以上医院的可能性较小，而受教育程度较高的个体更有可能选择（OR = 3.29，95%CI：1.35，8.02）。咳嗽超过2周的个体更有可能选择县级及以上医院。但伴随症状的数量与医疗机构的选择没有显著关系。
本研究发现年龄、性别、居住地区和咳嗽特征与就医行为有关。值得注意的是，咳嗽时间过长（如>8周）的个体就医可能性较小。应根据本研究中发现的关键因素制定针对性措施，以指导人们更科学地就医。
