徐州市社区慢性阻塞性肺疾病患者直接经济负担研究

目的了解浦东新区社区医生慢性阻塞性肺疾病(COPD)认知情况，为COPD社区防治工作提供依据。方法从上海市浦东新区的46个社区卫生服务中心用单纯随机抽样法抽取325名医生进行面对面调查，应答率为99.1%，问卷调查社区医生一般情况、COPD防治相关知识和COPD管理认知情况。结果86.6%的医生认为肺功能检测是COPD诊断的必备条件，77.0%的医生认为稳定期COPD患者需要维持治疗，26.4%的医生认为稳定期COPD患者外配药品首选气雾剂，23.0%的医生认为长期吸氧可能产生依赖性，60.2%的医生以前接受过COPD相关知识培训，仅21.7%的医生知道COPD诊治指南的主要内容，49.7%的医生认为自身不具备提供COPD社区保健服务的能力，尤其缺乏社区管理指导能力和临床治疗指导能力。社区全科医生的COPD相关知识技能水平高于公卫医生，但是否接受过全科医师规范化培训并不影响全科医生的COPD相关知识技能水平。结论社区医生在COPD预防及患者诊疗方面存在不足，有必要完善社区肺功能仪等相关设备的配置，并加强COPD专业知识和技能系统化培训，并且需要完善全科医师规范化培训制度，强化其中的COPD防治相关内容，切实提升社区医生的COPD防治能力。

Pharmacoeconomics in COPD:lessons for the future

ObjectiveTo 1investigate the cognition of chronic obstructive pulmonary disease (COPD) among community doctors in Pudong New Area, and to provide the basis for COPD community prevention and treatment.MethodsA total of 325 community doctors were selected for face to face investigation by simple random sampling from 46 communities in Shanghai Pudong New Area.The response rate was 99.1%.Questionnaires surveyed the general conditions, COPD prevention-related knowledge, and COPD management awareness with community doctors.ResultsIn the course of investigation, 86.6% of community doctors considered that pulmonary function testing was a prerequisite for the diagnosis of COPD; 77.0% of community doctors believed that patients with stable COPD needed maintenance treatment; 26.4% of community doctors considered that aerosols were the first choice of external medicine for patients with stable COPD; 23.0% of community doctors considered that long-term oxygen inhalation might cause dependence; 60.2% of respondents had previously been trained in COPD related knowledge.Only 21.7% knew the main content of the COPD diagnosis and treatment guidelines.And 49.7% of respondents believed that they did not have the ability to provide COPD community with health services, especially they lacked the ability for community management guidance and clinical treatment guidance.Community general doctors had higher levels of COPD-related knowledge and skills than public health doctors, but whether or not they had received standardized training for general practitioners did not affect their COPD-related knowledge and skills.ConclusionThere are deficiencies with community doctors in their prevention, diagnosis and treatment of COPD.It is necessary to improve the configuration of relevant equipment such as lung function meters, and to strengthen the systematic training of COPD professional knowledge and skills.It is also necessary to improve the standardized training system for general doctors and strengthen the relevant content of COPD prevention, and to effectively improve the ability of community doctors to prevent and control COPD.