| 慢性阻塞性肺疾病诊治指南 (2021年修订版) |
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| 引用本文： | 刘岚, 王旭明, 莫怡, 李锦波, 李国晖, 李芹, 左梅, 黄友, 蔡乐. 云南省农村慢性阻塞性肺疾病患者疾病负担及其影响因素分析[J]. 中国公共卫生, 2022, 38(12): 1555-1559. DOI: 10.11847/zgggws1137807 |
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| 作者姓名： | 刘岚 王旭明 莫怡 李锦波 李国晖 李芹 左梅 黄友 蔡乐 |
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| 作者单位： | 1.昆明医科大学公共卫生学院，云南 昆明 650500;2.昆明医科大学第一附属医院呼吸与危重症医学科 |
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| 基金项目： | 国家自然科学基金（72064026）；云南省创新团队培育计划（202005AE160002）；云南省科技厅 – 昆医联合专项资助项目（202101AY070001 – 098） |
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| 摘 要： | 目的 分析云南省农村慢性阻塞性肺疾病（COPD）患者的疾病经济负担及其影响因素，为制定减轻云南省农村COPD疾病经济负担的卫生政策和措施提供科学依据。 方法 于2020年11月 — 2021年11月采用多阶段分层随机抽样方法在云南省抽取7572名 ≥ 35岁农村常住居民进行问卷调查和肺功能检查，计算其中确诊为COPD患者的直接和间接疾病经济负担，并应用结构方程模型分析其影响因素。 结果 云南省7572名 ≥ 35岁农村居民中，患COPD者954例，COPD患病率为12.6 %；COPD患者的人均疾病经济负担为5787.2元，其中人均直接经济负担为5700.5元（98.5 %），人均间接经济负担为86.7元（1.5 %）；直接经济负担中，人均住院费、门诊费、药费和交通及住宿费分别为3020.7、1189.1、1418.6和72.1元。结构方程模型分析结果显示，住院情况（包括住院天数和住院机构）、1年内门诊次数和COPD患病对生活工作的影响（对工作影响、对做家务和日常生活影响）均对疾病经济负担有直接影响，其标准化路径系数分别为 0.43、0.36和 0.27；住院天数和住院机构的标准化路径系数分别为0.41和0.40；对工作影响、做家务和日常生活影响的标准化路径系数分别为0.26、0.23和0.23。 结论 云南省农村COPD患者的疾病经济负担较重，早诊早治、减少患者的住院天数和降低住院机构的级别有助于减轻其疾病经济负担。
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| 关 键 词： | 慢性阻塞性肺疾病(COPD) 疾病经济负担 影响因素 农村 |
| 收稿时间： | 2021-12-23 |
Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health Study): a national cross-sectional study |
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| LIU Lan, WANG Xu-ming, MO Yi, . Economic burden of chronic obstructive pulmonary disease patients and its influencing factors in rural Yunnan province: a population-based study[J]. Chinese Journal of Public Health, 2022, 38(12): 1555-1559. DOI: 10.11847/zgggws1137807 |
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| Authors: | LIU Lan WANG Xu-ming MO Yi |
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| Affiliation: | 1.School of Public Health, Kunming Medical University, Kunming, Yunnan Province 650500, China |
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| Abstract: | Objective To analyze the economic burden of patients with chronic obstructive pulmonary disease (COPD) and its influencing factors in rural regions of Yunnan province and to provide evidence for formulating health policies and measures to reduce the economic burden. Methods Face-to-face interview with a self-designed questionnaire and lung function test were conducted among 7 704 permanent residents at ages of 35 years and above recruited using stratified multistage random sampling in rural regions of Yunnan province from November 2020 to November 2021. Both direct and indirect cost of COPD patients were estimated and the influencing factors of the cost were analyzed with structural equation modeling. Results Among the 7 572 participants with complete information, 954 COPD patients were diagnosed, with a prevalence rate of 12.6%. The estimated average annual COPD-related expenditure per patient was 5 787.2 Yuan (RMB); in which, 98.50% (5 700.5 Yuan) and 1.50% (87.2 Yuan) was direct and indirect cost. For the direct expenditure, the cost of hospitalization, outpatient service, medication, and accommodation/transportation were 3 020.7, 1 189.1, 141 8.6, and 72.1 Yuan. The results of structural equation model analysis indicated that the COPD patients′ economic burden was associated with the condition of hospitalization, frequency of outpatient visits within one year and the impact of the disease on patients’ life and work, with the standardized regression coefficient of 0.43, 0.36 and 0.27. The standardized regression coefficient for the length of hospital stay and the type of medical institution were 0.41 and 0.40; while the standardized regression coefficient for the impact of the disease on daily work, housework and daily life was 0.26, 0.23 and 0.23, respectively. Conclusion The economic burden of rural COPD patients is relatively high in Yunnan province. The study results suggest that early diagnosis and treatment of the disease, reducing duration of hospitalization and the level of medical institution providing hospitalization service could alleviate the economic burden of the rural COPD patients. |
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| Keywords: | chronic obstructive pulmonary disease economic burden of disease influencing factor rural region |
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