Objective: To describe direct economic burden of chronic obstructive pulmonary disease (COPD) patients and its influence factors in the communities of Chengdu City.
Methods: 446 patients in 6 communities where community health service was trialed were selected by random clustering sampling as study object. Each patient was interviewed in their home by using a self-designed questionnaire, and medical records were abstracted as an assistant means. The main items involved in the questionnaire included general social and demographic characteristics, COPD related contents and attitude to COPD, as well as direct economic burden and average income in the past years.
Results: (1) The median of annual direct economic burden was 1280 Yuan for each community COPD patient. There were no significant differences between male and female patients, and among various age groups. The median of annual direct economic burden of first episode COPD was 1540 Yuan for each patient, and that of COPD was 1090 Yuan for each chronic patient. The annual direct economic burden of first episode was significantly higher than that of chronic patients (P < 0.05). The costs of out-patient, hospitalization, accommodation of hospitalization and treatment at home of middle-aged patients were significant higher than that of old-aged patients (P < 0.05), and that of long-term self-expended drugs were significant lower than that of old-aged patients (P < 0.05). (2) The annual general medical cost of hospitalization, outpatient, and long-term self-expended drugs of community COPD patients were equal to 91.77% of annual general medical cost of all patients. The proportion of annual general medical cost of all patients in winter among the whole year was 50.17%. (3) The main influence factors of medical cost fur COPD patients were hospitalization visits, disease condition, attitude to COPD, occupation and the pattern of medical burden.
Conclusion: The direct economic burden of community COPD patients was heavy in Chengdu, which embodied in that the medical costs were close to 1/4 of average annual income of investigating population. Therefore, measures need to be made by our nation and the influence factors should be intervened so that the direct economic burden of community COPD patients will be decreased in this city.