Determinants of health care-seeking delay among tuberculosis patients in Shandong Province, China

Background: It is beneficial for tuberculosis patients to seek health care in time. The aim of this study was to understand the situation of initial health care-seeking delay among tuberculosis patients in eastern China, and explore its influencing factors, to provide a basis for formulating related polices and reducing its transmission. Methods: A cross-sectional survey was conducted in six counties of Shandong Province, China, and we selected study sites by multi-stage random sampling. Subjects were pulmonary tuberculosis patients registered with the county tuberculosis dispensaries at study sites that completed treatment during the period October 2006 to September 30, 2007. Results: For the 819 cases of pulmonary tuberculosis, the median initial health care-seeking delay time was 6 days, and 49.8% of them were initial health care-seeking delayed. The logistic regression analysis showed that marriage (odds ratio = 0.354, 95% confidence interval: 0.193-0.650) and knowledge of the national tuberculosis subsidy policy (odds ratio = 1.753, 95% confidence interval: 1.258-2.441) were associated with initial health care-seeking delay. Conclusion: Changing the perception of patients and popularizing the national tuberculosis subsidy policy will do well towards reducing initial health care-seeking delay.