| The character of chronic obstructive pulmonary disease (COPD) is that airflow is limited. COPD mainly includes chronic obstructive tracheobronchiti and chronic obstructive pulmonary emphysema which is not completely reversible. In the world including China, COPD is a common disease and often leads to death. As WHO estimated, COPD was ranked the twelfth among main deseases causing death and disability in 1990, and it will be the fifth in 2020. It is estimated by WHO that the prevalence of COPD was 1013 per one hundred thousand in the world in 2001. For men, the prevalence was 1206 per one hundred thousand, and for women, was 810 per one hundred thousand. The highest prevalence of COPD is in West Pacific that was 1675 per one hundred thousand, and the lowest is in Africa that was 179 per one hundred thousand. The high prevalence in China leads to high prevalence in West Pacific. The total prevalence rate in rural China is 3 percent. For men and women, the prevalence is 4.21 percent and 1.84 percent respectively.The research on direct and indirect economic burden is never carried out in China and nobody did any survey about the factors which influence the economic burden. We did this research in order to show the economic burden brought by COPD in quanlity, analyze the main factors influencing the economic burden and provide policy suggestions about controlling the economic burden according to the factors.We chose Laiyang county, Gaotang county, and Xiajin county as the study sites. The first county's economic level is higher in Shandong and the latter two sites' economic level is lower in Shandong. The materials collected from household survey from October, 2005 to May, 2006. With the methods of descriptive analysis and multiple factor statistics, the study analysed the social and health status, the direct and indirect economic burden of COPD, and the main factors influencing both the direct and indirect economic burden.It shows that COPD brought heavy burden to Chinese rurual residents. The major results include: 1) Rurual COPD patients are old with low education degree and low income. More than half of them were retired from illness. Lacking health insurance is a common phenomenon. 82.5 percent of them were active smokers and 34.3 percent of them were passive smokers. 2) Most of COPD patients were ill for more than 8 years. They often go to see doctors in village clinics and town hospitals, almost half of them are satisfied by the effect of treatment. The top reason for that they are dissatisfied with health service is too few doctor visits. 3) The life quality of rurual COPD patients is at middle level. The ranking of four respects of life quality from better to worse is physical status, common feeling, psychologic status and social function. 4) In the past one year, the direct medical expenditure was 1178 Yuan per patient, the indirect medical expenditure is 448 Yuan per patient and the indirect economic burden is 2580 Yuan per patient. In indirect economic burden, the loss due to absenting from work for patient and familie menbers was 1035 Yuan and 121 Yuan respectively. 5) The significant factors influencing direct medical expenditure are age, grade of hospital often visited, the times going to see doctors in the past one year, social fuction, psychologic status, the income of family and the status of smoking. The significant factors influencing indirect medical expenditure are income of patient, social status, age, grade of hospital often visited, gender and physical status. The significant factors influencing indirect economic burden are age and income of patient.Policy implications from this study are as follows. 1) Carry out health education about COPD. 2) Push new cooperative medical system combined with medicaid. 3) Enhance the system of bi-transfering patients. 4) Use more Chinese traditional medicine. |
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