慢性阻塞性肺疾病对中国部分城市患者生命质量和经济负担的影响

Impact of chronic obstructive pulmonary disease on quality of life and economic burden in Chinese urban areas

目的了解COPD对城市患者生命质量的影响，以及COPD造成的经济负担。方法于2006年7—10月采用横断面调查方法，对北京、上海、广州、成都、沈阳和西安等6个城市24家医院723例确诊的COPD患者进行面对面访问，调查内容包括患者的社会人口学信息、目前患病情况、生命质量（采用圣乔治呼吸问卷）、过去1年医疗资源利用情况，以及其他相关费用。对调查所获得信息主要采用描述性分析。结果被调查COPD患者男性占73％（526／723），平均年龄（67±10）岁。COPD患者圣乔治呼吸问卷症状平均得分为（49±24）分，活动部分得分为（57±23）分，影响部分得分为（46±23）分，总分平均为（50±21）分，均明显高于健康人群得分。COPD患者的年人均直接医疗费用（包括门诊费用、住院费用和自我购药费用）为11744元，直接非医疗费用为1570元。在职COPD患者每人每年因病平均误工17d，家属因照顾COPD患者平均每年误工14d。结论COPD严重影响城市患者的生命质量，并给患者的家庭和社会造成沉重的经济负担。应大力加强对COPD的干预，特别是对稳定期COPD的干预，以减少COPD的发病和急性加重。

Objective To assess the impact of chronic obstructive pulmonary disease （COPD） on the quality of life and economic burden in Chinese urban areas. Methods COPD patients （ n = 723 ） were interviewed face-to-face in outpatient departments in 6 large cities in China. The questionnaire included social and demographic information, current health status, quality of life （SGRQ）, and medical expenditure on outpatient visit, hospitalization, medicine purchasing in medicine stores in the last 12 months, and other expenditures related with COPD were also collected. All the data were analyzed using descriptive method. Results Of the 723 COPD patients interviewed, 73% were male and the average age was 67 years old. The average symptom score of SGRQ was 49 ± 24, activity score 57 ± 23, impact score 46± 23 and total score 50± 21, which were all higher than scores of the healthy populations. The average direct medical cost （including outpatient cost, inpatient cost, and medicine purchasing cost） was 11 744 RMB yuan annually. The direct non-medical cost （including transportation fee, nutrition fee, and nursing fee） was 1570 RMB yuan. 36% of the patients in work had an average of 17 working days lost in the last 12 months because of COPD, while 17% of their relatives had an average of 14 working days lost for caring the patients. Conclusions COPD has a serious impact on the quality of life of Chinese urban patients and places a heavy economic burden on their family and the society. Management of COPD should be improved for patients at stable conditions, so as to reduce the incidence and exacerbation of COPD.