云南省纳西族居民慢性阻塞性肺疾病的疾病经济风险及影响因素

目的  分析云南省纳西族居民慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）的疾病经济风险及影响因素。 方法  采用多阶段分层随机抽样的方法，对云南省玉龙县≥35岁的纳西族居民进行现场问卷调查及肺功能检查。 结果  云南省纳西族COPD的患病率为17.66%，COPD患者的疾病经济风险是观察人群的1.53倍（RR=1.53）；COPD患者家庭的灾难性卫生支出和因病致贫发生率分别为13.49%和18.58%。多因素Logistic回归分析模型分析结果显示，COPD患者家庭（OR=2.378，95% CI：1.681~3.363，P＜0.001）和人均年收入越低的家庭（OR=0.467，95% CI：0.332~0.656，P＜0.001）发生灾难性卫生支出的可能性越高。人均年收入越低（OR=0.028，95% CI：0.016~0.047，P＜0.001）和家里无厕所的家庭（OR=0.561，95% CI：0.402~0.784，P＜0.001），其因病致贫发生的可能性越高。 结论  云南省纳西族居民COPD患者的疾病经济风险较高，应加强对COPD患者和低收入家庭的经济与医疗支持。

Analysis on disease economic risk and influencing factors of chronic obstructive pulmonary disease among Na Xi ethnic minority in Yunnan Province

  Objective  The aim of this study was to analyze the disease economic risk and influencing factors of chronic obstructive pulmonary disease (COPD) among Na Xi ethnic minority in Yunnan Province.  Methods  A multi-stage stratified random sampling method was used to conduct on-site questionnaire survey and lung function tests among Na Xi ethnic minority residence aged ≥ 35 years in Yulong County, Yunnan Province.  Results  The prevalence of COPD among Na Xi ethnic minority in Yunnan Province was 17.66%. The economic risk of COPD patients was 1.53 times higher than that of the observed population (RR=1.53), and the incidence of catastrophic health care expenditures and poverty due to illness among households with COPD patients was 13.49% and 18.58%, respectively. The results of multivariate logistic regression analysis showed that households with COPD patients (OR=2.378, 95% CI:1.681-3.363, P < 0.001) and households with lower per capita annual income (OR=0.467, 95% CI:0.332-0.656, P < 0.001) were more likely to experience catastrophic health care expenditure. Households with lower per capita annual income (OR=0.028, 95% CI:0.016-0.047, P < 0.001) and households without toilets (OR=0.561, 95% CI:0.402-0.784, P < 0.001) were more likely to experience poverty due to illness.  Conclusions  The economic risk of COPD is relatively high among Na Xi ethnic minority in Yunnan Province. We should enhance economic and medical support for households with COPD patients and households with low income.