Patient delays and medical care delays among elderly tuberculosis patients in Chongqing, China

Abstract Background China is one of the countries with a high global burden of tuberculosis (TB). Chongqing is the most populous city in southwestern China and one of the provinces with a high degree of aging. This study aimed to analyse the delays in consultation and diagnosis of elderly patients with tuberculosis in Chongqing, to explore the reasons behind these delays, and to propose strategies to address these problems. Methods Based on the TB data extracted from the China Tuberculosis Management Information System from 2016 to 2022, TB patients aged ≥ 65 years with complete registration information who were currently residing in Chongqing Municipality during the 7-year period from 2016 to 2022 were selected. One-way c2 test and multifactorial logistic regression were used to analyse the factors affecting delay in consultation and delay in the healthcare system among elderly TB patients. Results. A total of 29,337 patients were included in this study. Between 2016 and 2020, there was a decreasing trend in both consultation delays and healthcare system delays in Chongqing. The median time of visit delay was 36 (15, 91) visit delay rate was 76.1%; the median time of healthcare system delay was 1 (1, 6) and healthcare system delay rate was 12.4%. Women (OR = 1.15,95%Cl:1.077,1.227), elderly TB patients who belonged to a mobile population (OR = 1.157,95%Cl:1.031,1.297) with comorbidities (OR = 1.084,95%Cl:1.026,1.145) were at higher risk of visit delay. Unemployed (OR = 1.349,95%Cl:1.198,1.520) and retired (OR = 1.820,95%Cl:1.641,2.019), mobile (OR = 1.445,95%Cl:1.272,1.642), with comorbidities (OR = 1.113,95%Cl:1.04,1.20), and Older TB patients who were first seen in the main urban area (OR = 1.721,95%Cl:1.566,1.891) were more likely to experience delays in the healthcare system. Conclusions Both TB visit delays and healthcare system delays have improved in Chongqing, but TB visit delays are still more prominent in the elderly population. To effectively address this problem, it is particularly important to strengthen health education efforts for the elderly population and key TB target groups, to enhance the professional capacity of primary health care institutions in TB screening, and to promote the in-depth application of Internet technology in TB prevention and control. The implementation of these measures will be of inestimable value in reducing delays in patient consultation and optimising the response efficiency of the healthcare system.