Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis

BackgroundTuberculosis is the most common complication of pneumoconiosis, which accelerates the progression of pneumoconiosis. Pneumoconiosis combined with tuberculosis is a major health risk. ObjectiveTo understand the outpatient health service utilization for patients of pneumoconiosis combined wi...

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Main Authors: Fengping LUO, Huanqiang WANG, Dianfeng CAO, Tao LI
Format: Article
Language:English
Published: Editorial Committee of Journal of Environmental and Occupational Medicine 2024-02-01
Series:环境与职业医学
Subjects:
Online Access:http://www.jeom.org/article/cn/10.11836/JEOM23200
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author Fengping LUO
Huanqiang WANG
Dianfeng CAO
Tao LI
author_facet Fengping LUO
Huanqiang WANG
Dianfeng CAO
Tao LI
author_sort Fengping LUO
collection DOAJ
description BackgroundTuberculosis is the most common complication of pneumoconiosis, which accelerates the progression of pneumoconiosis. Pneumoconiosis combined with tuberculosis is a major health risk. ObjectiveTo understand the outpatient health service utilization for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. MethodsA stratified random sampling combined with non-random sampling was used to select 11181 pneumoconiosis patients in 27 provincial administrative regions (excluding Shanghai, Tianjin, Hainan, Tibet Autonomous Region, Taiwan, Hongkong and Macao Special Administrative Regions) from December 2017 to June 2021. A self-constructed questionnaire, i.e. Health Seeking Behaviors of Pneumoconiosis Patients and Their Influencing Factors, was used, which included basic information, outpatient and inpatient service utilization, and influencing factors of medical treatment behaviors of pneumoconiosis patients. The effective recovery rate of the questionnaire was 90.7%. All patients of pneumoconiosis combined with tuberculosis (n=762) were included as the study subjects. The difference of outpatient utilization in the past two weeks, choosing medical institutions, and the reasons of not seeking medical treatment between urban and rural areas, and the influencing factors of outpatient service utilization were analyzed. ResultsThe study subjects were mainly silicosis combined with tuberculosis (502 cases, 65.9%) and coal workers' pneumoconiosis combined with tuberculosis (232 cases, 30.5%), aged (58.6±12.5) years old. The main region was Western China (45.1%), followed by Eastern China (22.1%), Centeral China (20.2%), and Northeastern China (12.6%). The outpatient utilization rate in the past two weeks was 38.5% (293/762), and the main medical institutions consulted were municipal or provincial hospitals (32.0%), district or county hospitals (28.6%), and township hospitals or health service centers (17.5%). Short distance (20.7%), the availability of specialist outpatient services (16.7%), high level of medical care (14.8%), and low medical cost (12.3%) were the main reasons in choosing medical institutions. Higher proportion of patients seeking medical services due to acute exacerbation in rural areas was reported than in urban areas in the past two weeks (P<0.01). In addition to being hospitalized (113 cases, 41.4%) and self-purchasing medicine (46 cases, 16.8%), the reasons for not seeking medical treatment were self-perceived mild symptoms (15.0%) and high medical cost without reimbursement (9.5%). The multiple regression results showed that outpatient rate for patients of pneumoconiosis combined with tuberculosis in the western region was higher than that in the eastern region (OR=1.66, 95%CI: 1.03, 2.68); patients with an annual personal income of 10000-35500 yuan had a higher outpatient rate than the > 35500 yuan income group (OR=2.54, 95%CI: 1.49, 4.36); the outpatient rate of silicosis patients was higher than that of coal workers' pneumoconiosis (OR=1.83, 95%CI: 1.23, 2.72); the outpatient rate of patients with clinically diagnosed cases (no classified stage of pneumoconiosis) was higher than that of patients with stage I pneumoconiosis (OR=2.32, 95%CI: 1.24, 4.31). Exacerbation of pneumoconiosis-related symptoms in past two weeks (OR=4.26, 95%CI: 2.89, 6.28), occupational injury insurance (OR=0.49, 95%CI: 0.30, 0.80), and hospitalization in past one year (OR=2.37, 95%CI: 1.41, 3.97) were the main factors influencing the outpatient health service utilization among patients of pneumoconiosis combined with tuberculosis.ConclusionThe outpatient rate of patients of pneumoconiosis combined with tuberculosis is higher than that of patients of pneumoconiosis without tuberculosis. The utilization of outpatient services is related with disease factors and socio-economic security factors.
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spelling doaj.art-60ae5fb70665433795313bd24a478dd92024-03-07T05:27:39ZengEditorial Committee of Journal of Environmental and Occupational Medicine环境与职业医学2095-99822024-02-0141213914510.11836/JEOM2320023200Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosisFengping LUO0Huanqiang WANG1Dianfeng CAO2Tao LI3National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, ChinaNational Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, ChinaDepartment of Occupational Diseases, Zibo Prevention and Treatment Hospital for Occupational Diseases, Zibo, Shandong 255067, ChinaNational Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, ChinaBackgroundTuberculosis is the most common complication of pneumoconiosis, which accelerates the progression of pneumoconiosis. Pneumoconiosis combined with tuberculosis is a major health risk. ObjectiveTo understand the outpatient health service utilization for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. MethodsA stratified random sampling combined with non-random sampling was used to select 11181 pneumoconiosis patients in 27 provincial administrative regions (excluding Shanghai, Tianjin, Hainan, Tibet Autonomous Region, Taiwan, Hongkong and Macao Special Administrative Regions) from December 2017 to June 2021. A self-constructed questionnaire, i.e. Health Seeking Behaviors of Pneumoconiosis Patients and Their Influencing Factors, was used, which included basic information, outpatient and inpatient service utilization, and influencing factors of medical treatment behaviors of pneumoconiosis patients. The effective recovery rate of the questionnaire was 90.7%. All patients of pneumoconiosis combined with tuberculosis (n=762) were included as the study subjects. The difference of outpatient utilization in the past two weeks, choosing medical institutions, and the reasons of not seeking medical treatment between urban and rural areas, and the influencing factors of outpatient service utilization were analyzed. ResultsThe study subjects were mainly silicosis combined with tuberculosis (502 cases, 65.9%) and coal workers' pneumoconiosis combined with tuberculosis (232 cases, 30.5%), aged (58.6±12.5) years old. The main region was Western China (45.1%), followed by Eastern China (22.1%), Centeral China (20.2%), and Northeastern China (12.6%). The outpatient utilization rate in the past two weeks was 38.5% (293/762), and the main medical institutions consulted were municipal or provincial hospitals (32.0%), district or county hospitals (28.6%), and township hospitals or health service centers (17.5%). Short distance (20.7%), the availability of specialist outpatient services (16.7%), high level of medical care (14.8%), and low medical cost (12.3%) were the main reasons in choosing medical institutions. Higher proportion of patients seeking medical services due to acute exacerbation in rural areas was reported than in urban areas in the past two weeks (P<0.01). In addition to being hospitalized (113 cases, 41.4%) and self-purchasing medicine (46 cases, 16.8%), the reasons for not seeking medical treatment were self-perceived mild symptoms (15.0%) and high medical cost without reimbursement (9.5%). The multiple regression results showed that outpatient rate for patients of pneumoconiosis combined with tuberculosis in the western region was higher than that in the eastern region (OR=1.66, 95%CI: 1.03, 2.68); patients with an annual personal income of 10000-35500 yuan had a higher outpatient rate than the > 35500 yuan income group (OR=2.54, 95%CI: 1.49, 4.36); the outpatient rate of silicosis patients was higher than that of coal workers' pneumoconiosis (OR=1.83, 95%CI: 1.23, 2.72); the outpatient rate of patients with clinically diagnosed cases (no classified stage of pneumoconiosis) was higher than that of patients with stage I pneumoconiosis (OR=2.32, 95%CI: 1.24, 4.31). Exacerbation of pneumoconiosis-related symptoms in past two weeks (OR=4.26, 95%CI: 2.89, 6.28), occupational injury insurance (OR=0.49, 95%CI: 0.30, 0.80), and hospitalization in past one year (OR=2.37, 95%CI: 1.41, 3.97) were the main factors influencing the outpatient health service utilization among patients of pneumoconiosis combined with tuberculosis.ConclusionThe outpatient rate of patients of pneumoconiosis combined with tuberculosis is higher than that of patients of pneumoconiosis without tuberculosis. The utilization of outpatient services is related with disease factors and socio-economic security factors.http://www.jeom.org/article/cn/10.11836/JEOM23200pneumoconiosistuberculosisoutpatient health service utilizationhealth seeking behavior
spellingShingle Fengping LUO
Huanqiang WANG
Dianfeng CAO
Tao LI
Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
环境与职业医学
pneumoconiosis
tuberculosis
outpatient health service utilization
health seeking behavior
title Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
title_full Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
title_fullStr Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
title_full_unstemmed Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
title_short Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
title_sort outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis
topic pneumoconiosis
tuberculosis
outpatient health service utilization
health seeking behavior
url http://www.jeom.org/article/cn/10.11836/JEOM23200
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AT dianfengcao outpatienthealthserviceutilizationanditsinfluencingfactorsamongpneumoconiosispatientscombinedwithtuberculosis
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