Analysis Of Prevalence,Awareness And Treatment Rate Of Chronic Obstructive Pulmonary Disease And Disease Economic Risk Among Na Xi Ethnic Minority In Yunnan

Objectives:The aim of study was to analyze the prevalence,awareness,treatment of chronic obstructive pulmonary disease(COPD)among Na Xi ethnic minority in Yunnan,and to assess the disease economic risk of COPD among Na Xi ethnic minority.Providing theoretic evidences of management and prevention of COPD for local medical institutions by analyzing the influencing factors of prevalence and disease economic risk.Methods:July to August 2018,a multi-stage stratified random sampling method was used to 2531 local residents of the Na Xi ethnic for age ≥35 in Yulong County,Yunnan.And the investigator conducted a questionnaire survey,physical and lung function tests for them.The basic demographic information of local Na Xi residents,the prevalence,awareness and treatment of COPD,and relevant indicators for evaluating the economic risk of COPD patients were collected by investigators through questionnaires.The investigator carried out on-site measurement and recording of the height,weight,waist circumference,lung function and other data of the survey subjects.Data is entered by Epidata3.0,and statistical analysis is performed by SPSS22.0 software.The basic demographic characteristics are statistically described,and Chi-square test is used to compare different rates or constituent ratios.The analysis of relative influencing factors of COPD prevalence,catastrophic health expenditure and poverty due to illness by logistic regression,α=0.05.Results:Among the study population,the prevalence,awareness and treatment rate of COPD was 17.70%,17.40%and 16.10%,respectively.The prevalence rate was 19.00%for men and 16.30%for women.There was no difference in the prevalence between men and women.The Na Xi ethnic minority aged 75 and above have the highest prevalence rate.Prevalence,awareness and treatment rate of COPD increased with age(χ2=40.900,χ2=10.765,χ2=11.459,P<0.05).The awareness and treatment rate of COPD among those with junior high school and above is higher than those with primary school and below(χ2=18.333,χ2=17.340,P<0.001).The awareness and treatment rates of COPD for those with a per capita annual income>5000 are higher than those with a per capita annual income ≤ 5000(χ2=6.460,χ2=6.661,P<0.05).The results of binary logistic regression analysis showed that individuals with family history of COPD(OR=3.810,95%CI:1.839～7.893)and smokers(OR=1.834,95%CI:1.309-2.571)had higher risk of developing COPD than their counterparts,whereas obese people had lower risk of developing COPD than their counterparts(OR=0.583,95%CI:0.390～0.872).The older individuals(OR=1.039,95%CI:1.016-1.062),individuals with the higher education level(OR=2.086,95%CI:1.004-4.333),and individuals with family history of COPD(OR=23.919,95%CI:6.231～91.825),their knowledge of COPD was better.The older individuals(OR=1.041,95%CI:1.017～1.065),individuals with the higher education level(OR=2.079,95%CI:1.010～4.412),and individuals with family history of COPD(OR=2.079,95%CI:1.010～4.412),accept treatment for COPD was easier.The per capita direct,indirect and economic burden among COPD patients was 2827.82 Yuan,105.00 Yuan and 2932.82 Yuan,respectively.The per capita direct of COPD patients is dominated by hospitalization expenses(53.61%),followed by medicine expenses(35.29%).The economic risk of COPD patients was 1.53 times higher than that of the observed population(RR=1.53).The incidence of catastrophic health care expenditures and poverty due to illness among households with COPD patients was 13.49%and 18.58%,respectively.Among them,families with COPD patients with access to medical services less than 30 minutes is lower than families with COPD patients with access to medical services≥ 30 minutes have a lower incidence of poverty due to illness(χ2=0.456,P=0.033).The incidence of catastrophic health expenditure and the incidence of poverty in COPD patients with a per capita annual income of more than 5000 yuan are lower than those with COPD patients with a per capita annual income of≤5000 yuan(χ2=9.136,P=0.003;χ2=8.320,P=0.004).The results of multivariate logistic regression analysis showed that households with COPD patients(OR=2.378,95%CI-1.681～3.363)and households with lower per capita annual income(OR=0.497,95%CI:0.332～0.656)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)and households without toilets(OR=0.561,95%CI:0.402～0.784)were more likely to experience poverty due to illness.Conclusions:The findings indicate a relatively higher prevalence of COPD while a lower awareness and treatment rate of COPD among Na Xi ethnic minority in Yunnan.The incidence of catastrophic health expenditures and experience poverty due to illness are relatively high of COPD patients among Na Xi ethnic minority in Yunnan,and both the patients and their families face higher economic risks of the disease.Prevention and treatment of COPD in Yulong County,Yunnan:(1)The publicity and education of health knowledge of COPD should be strengthened by local residents.(2)It is necessary to carry out COPD prevention work for individuals who have a family history of COPD and smokers.(3)It is necessary to strengthen the overall knowledge of Na Xi ethnic minority in Yulong County,Yunnan on the prevention and treatment of COPD.Especially for individuals with family history of COPD and smokers in this area,lung function testing,monitoring and health knowledge popularization are carried out.(4)It can be targeted to strengthen the propaganda and education of COPD knowledge for for the younger individuals,the low-educated individuals and the low per capita annual income.(5)It is recommended that the region increase medical services and financial support for families with low-income and households with COPD patients.