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与就医延迟相关的因素:中国中老年人的证据。

Factors Associated with the Delay in Seeing a Doctor: Evidence of Chinese Middle-Aged and Older Adults.

作者信息

Qin Shangren, Ni Xiaoyan, Ding Ye

机构信息

School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China.

Cangqian Street Community Health Service Center, Hangzhou, Zhejiang, People's Republic of China.

出版信息

J Multidiscip Healthc. 2023 Dec 28;16:4239-4253. doi: 10.2147/JMDH.S443683. eCollection 2023.

Abstract

BACKGROUND

There have been few studies concerning delayed medical attention among middle-aged and older adults, and in-depth analyses of delay duration and symptoms have been lacking.

METHODS

In this cross-sectional study exploiting a face-to-face questionnaire survey, we investigated delays in seeing a doctor among ≥ 45-year-old people in Zhejiang, China over the past year, and analyzed relevant influencing factors through logistics regression.

RESULTS

A total of 1034 people aged ≥45 years were enrolled, whose overall occurrence of delay in seeing a doctor was 28.24% (23.00% for older adults aged ≥60 years). Factors like the presence of 2 chronic diseases, intense social loneliness, and more health care needs contributed to the occurrence of delay in seeing a doctor (OR (95% CI) = 2.102 (1.252-3.529); OR (95% CI) = 1.030 (1.002-1.059); OR (95% CI) = 1.049 (1.002-1.099). Contrastively, factors like convenient access to medical care and good self-reported health status inhibited such occurrence OR (95% CI) = 0.321 (0.199-0.519); OR (95% CI) = 0.369 (0.183-0.745). The foremost reason was wanting to wait and see if the problem would get better on its own (117, 40.07%). Respiratory system disease (14.90%), dental problems (13.82%), and cardiac disease (13.61%) constituted the top 3 types of diseases whose treatments were delayed. Additionally, for the majority of older adults, the delay duration was 1-2 weeks (99, 33.90%), and the economic burden was the cause of the longest delay in seeing a doctor among middle-aged and older adults.

CONCLUSION

To alleviate the problem of delay in seeing a doctor among middle-aged and older adults, their families and society should enhance care for them and reduce their sense of social loneliness. Emphasis should be placed by the government on helping middle-aged and older adults with financial difficulties so that their medical convenience can be improved.

摘要

背景

关于中老年人群延迟就医的研究较少,且缺乏对延迟时长和症状的深入分析。

方法

在这项采用面对面问卷调查的横断面研究中,我们调查了中国浙江45岁及以上人群过去一年的就医延迟情况,并通过逻辑回归分析相关影响因素。

结果

共纳入1034名45岁及以上人群,其总体就医延迟发生率为28.24%(60岁及以上老年人为23.00%)。患有2种慢性病、社交孤独感强烈和医疗保健需求较多等因素导致就医延迟的发生(比值比(95%置信区间)=2.102(1.252 - 3.529);比值比(95%置信区间)=1.030(1.002 - 1.059);比值比(95%置信区间)=1.049(1.002 - 1.099)。相反,就医便利和自我报告健康状况良好等因素抑制了这种情况的发生(比值比(95%置信区间)=0.321(0.199 - 0.519);比值比(95%置信区间)=0.369(0.183 - 0.745)。最主要的原因是想等着看问题是否会自行好转(117例,40.07%)。呼吸系统疾病(14.90%)、牙齿问题(13.82%)和心脏病(13.61%)是治疗延迟的前3类疾病。此外,对于大多数老年人来说,延迟时长为1 - 2周(99例,33.90%),经济负担是中老年人群就医延迟最长的原因。

结论

为缓解中老年人群就医延迟问题,其家庭和社会应加强对他们的关怀,减少他们的社交孤独感。政府应着重帮助经济困难的中老年人群,以改善他们就医的便利性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d2/10758318/ff2066f9c6b0/JMDH-16-4239-g0001.jpg

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