云南省农村居民慢性阻塞性肺疾病患病率及经济负担

目的分析云南省农村居民慢性阻塞性肺疾病(COPD)的患病现状及经济负担。方法采用两阶段分层抽样方法抽取云南省9396名18岁及以上的村民进行现场问卷调查。采用两步模型法估算其直接经济负担;用伤残调整寿命年(DALY)与人力资本法相结合,估算其间接经济负担;采用支付意愿法测算其无形经济负担。COPD的死亡资料、人口数据和人均国民生产总值数据分别来源于当地的疾病预防控制中心及统计局。结果云南省农村居民COPD的患病率为1.41%,其中男性患病率为1.72%,女性患病率为1.23%,男性患病率与女性患病率之间差异无统计学意义(χ2=7.113,P>0.05)。COPD死亡率为65.67/10万。COPD每千人口的DALY值为6.02,其中男性为6.73,女性为5.26,男性每千人口的DALY值略高于女性。云南省COPD患者的人均直接、间接和无形经济负担分别为4202.06、94.87和7051.95元,总的疾病经济负担为16767.65万元。男性COPD患者总疾病经济负担大于女性,差异有统计学意义(t=84.678,P<0.05)。结论云南省农村COPD患者的人均经济负担超出了患者的家庭年均收入,COPD给云南省农村居民造成了一定的经济负担。

Analysis of Prevalence and Economic Burden of Chronic Obstructive Pulmonary Disease in Rural Residents of Yunnan Province

Objective To estimate the prevalence of economic burden of chronic obstructive pulmonary disease （COPD） in rural residents in Yunnan Province. Methods 9396 rural residents aged 18 yrs and over were selected from two rural areas of Yunnan province by multistage cluster sampling method. The death data and the population data of COPD were collected from local Centers for Disease Control and Prevention, the data of GDP per capita were collected from the Bureau of Statistics. Direct economic burden of COPD was estimated by two-steps method, whereas disability adjusted life years （DALY） combined with human capital and willingness to pay method were used to measure indirect and intangible economic burden of COPD. Results The overall prevalence of COPD was 1.41%, and was 1.72% for males, 1.23% for females, there was no significant difference between the male and the female （P〉0.05）. The mortality rates per 100,000 population was 65.67. The DALY/1000 COPD population was 6.02, and 6.73 for male and 5.26 for female. The direct, indirect and intangible economic burden per capita of COPD was 4202.06 Yuan, 94.87 Yuan, and 7051.95 Yuan, respectively. The total economic burden of COPD was 167676500 Yuan. The total economic burden of COPD was higher in male than in female （P〈0.05）. Conclusion COPD has caused tremendous economic burden for the rural residents of Yunnan, and has been a major public health problem in rural areas of Yunnan province.