Analysis of factors influencing patient delay in tuberculosis patients in Northeast China: surveillance data from 2015 to 2024

Key findings from this study

• The study found that consultation delay affected 56.65% of TB patients in Shenyang City, with median delay duration of 18 days and an increasing trend from 2015 to 2024.
• The researchers demonstrate that female sex, age 60 years or older, ethnic minority status, positive pathology results, and farmer occupation independently increased consultation delay risk.
• The authors report that intracity mobility and patient detection through physical examination served as protective factors reducing consultation delay.

Overview

A retrospective analysis of 38,928 tuberculosis patients in Shenyang City from 2015 to 2024 examined delays in patient consultation for TB diagnosis and treatment. The study extracted patient data from the China Tuberculosis Information Management System and employed chi-square tests and binary logistic regression to identify demographic and clinical factors associated with consultation delays.

Methods and approach

Researchers analyzed basic information on TB patients from January 1, 2015, through December 31, 2024, using the China Tuberculosis Information Management System. Median and interquartile ranges characterized delay duration. Chi-square tests and binary logistic regression identified factors influencing consultation delay, with statistical significance set at p < 0.001.

Results

Among 38,928 patients, 22,051 (56.65%) experienced consultation delay. Median delay duration was 18 days (interquartile range 6-36 days). The delay rate increased significantly from 2015 to 2024 (χ² = 2235.857, p < 0.001). Female patients demonstrated elevated delay risk (OR = 1.185, 95% CI: 1.130-1.243). Patients aged 60 years or older showed increased delay likelihood (OR = 1.218, 95% CI: 1.018-1.458). Ethnic minorities exhibited greater delay risk (OR = 1.409, 95% CI: 1.252-1.585). Farmers demonstrated elevated delay risk compared to other occupational categories. Patients with positive pathology results had higher delay risk (OR = 1.296, 95% CI: 1.194-1.407). Intracity mobility served as a protective factor (OR = 0.573, 95% CI: 0.540-0.608). Patient identification through physical examination reduced delay risk (OR = 0.468, 95% CI: 0.276-0.794).

Implications

The escalating consultation delay rate in Shenyang City from 2015 to 2024 indicates worsening timeliness of TB diagnosis despite surveillance infrastructure. More than half of TB patients delay seeking consultation, extending disease duration and increasing transmission risk within communities. This pattern suggests gaps between disease onset awareness and healthcare access across multiple demographic groups.
Identified demographic and clinical risk factors enable targeted intervention strategies. Female patients, elderly populations, ethnic minorities, and agricultural workers require specialized outreach mechanisms. Risk stratification based on patient characteristics could direct resources toward populations with highest delay probability, potentially accelerating diagnosis timing.
Protective factors associated with intracity mobility and physical examination-based detection suggest benefits of active case-finding programs and increased patient movement accessibility. Healthcare systems implementing strengthened surveillance and screening initiatives may achieve earlier diagnosis. Reducing consultation delays requires multipronged approaches addressing occupational barriers, geographic mobility constraints, and awareness gaps across at-risk populations.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.