Institute of Disaster Medicine, Tianjin University, Tianjin, 300072, PR China.
General Courses Department, Army Military Transportation University of PLA, Tianjin 300161, PR China.
J Formos Med Assoc. 2022 Jul;121(7):1248-1256. doi: 10.1016/j.jfma.2021.11.003. Epub 2021 Nov 11.
Patient delay of COVID-19 patients occurs frequently, which poses a challenge to the overall epidemic situation. In this study, we aimed to evaluate the extent of patient delay, explore its factors, and investigate the effects of patient interval on epidemic situation.
A retrospective cohort study was conducted with 136 COVID-19 patients in Tianjin, China. Factors associated with patient delay were explored using logistic regression models. The relationship was investigated by spearman correlation analysis and mean absolute error between patient interval of lagging days and epidemic situation.
The factors associated with patient delay of COVID-19 patients were mainly the imported cases, the first presentation to a tertiary hospital, close contacts and spatial accessibility to fever clinic. The longer the patient intervals of lagging days, the greater the number of new-onset and confirmed cases in 3-4 and 5-7 days after the first day symptoms, respectively.
Identification and quarantine of close contacts, promoting the spatial accessibility to fever clinics and creating public awareness are crucial to shortening patient delays to flat the curve for COVID-19.
COVID-19 患者的延迟就诊现象经常发生，这对整体疫情防控构成了挑战。在本研究中，我们旨在评估患者延迟就诊的程度，探讨其影响因素，并研究患者间隔时间对疫情的影响。
本研究采用回顾性队列研究方法，纳入了中国天津的 136 例 COVID-19 患者。采用逻辑回归模型探讨与患者延迟就诊相关的因素。通过 Spearman 相关分析和滞后天数的患者间隔时间与疫情之间的平均绝对误差来研究两者之间的关系。
COVID-19 患者延迟就诊的相关因素主要包括输入性病例、首诊于三级医院、密切接触者和发热门诊的空间可达性。滞后天数的患者间隔时间越长，第 1 天症状后第 3-4 天和第 5-7 天新发病例和确诊病例的数量就越多。
识别和隔离密切接触者、促进发热门诊的空间可达性以及提高公众意识对于缩短 COVID-19 患者的延迟就诊时间、遏制疫情蔓延至关重要。
