To analyze the current status and influencing factors of patient delay and diagnosis delay among pulmonary tuberculosis patients aged 60 and above in Gansu Province, and to provide a reference for developing targeted tuberculosis prevention and control strategies for the elderly.

Based on pulmonary tuberculosis case data in Gansu Province from 2019 to 2022, descriptive statistical analysis and multivariable logistic regression analysis were used to investigate the current status and influencing factors of patient delay and diagnosis delay among elderly pulmonary tuberculosis patients.

Among 9 934 pulmonary tuberculosis patients aged ≥60 years, 7 143 cases (71.90%) experienced patient delay, and 1 073 cases (10.80%) experienced diagnosis delay. Among patients with delay, 3 278 cases (45.89%) had a patient delay time ≥7 weeks, and 315 cases (29.36%) had a diagnosis delay time ≥7 weeks. Multivariable logistic regression analysis showed that Tibetan ethnic group, Hui ethnic group, retreatment, and bacteriologically positive status were protective factors for patient delay, while Dongxiang ethnic group, manual laborers, retirees/other occupations, initial diagnosis at the municipal level, and presence of symptoms were risk factors for patient delay. Age ≥70 years, manual laborers, retirees/other occupations, and current diagnosis at the municipal level were protective factors for diagnosis delay, while Hui ethnic group and retreatment were risk factors for diagnosis delay.

The current situation of patient delay among pulmonary tuberculosis patients aged ≥60 years in Gansu Province is particularly severe. It is recommended to establish regionally tailored and differentiated prevention and control strategies, while promoting the decentralization of medical services to enable patients to access care closer to their places of residence, thereby reducing patient delay and diagnosis delay.