| ObjectivesTo understand the economic burden and influence factors for patients of chronic obstructive pulmonary disease(COPD)in pulmonary rehabilitation in Jiulongpo District,Chongqing.Provide economic basis for the government to allocate health resources reasonably.Meanwhile,propose corresponding intervention measures to offer reference opinions to clinical intervention.Besides,relieve patients'economic burden of disease and promote the effective implementation of pulmonary rehabilitation.MethodsThis study uses convenience sampling to select a total of 71 patients with COPD who received rehabilitation treatment in the rehabilitation hospital affiliated to Chongqing medical university in Jiulongpo District,Chongqing from January 2017 to December 2018.Survey items include general information survey of patients,financial burden of disease,disease history,prevention and rehabilitation.All data use Excel to establish a database and SPSS19.0 statistics software for analysis.The measurement data use`x±s or median and quartile(25%-75%digits),and the counting data are described by frequency and composition ratio.The independent sample test is used in the comparison between the metering data groups,and the disordered counting data mainly adopts(correction)?~2 test or Fisher precise probability method,and the single unit of ordered grade data adopts non-parametric rank and test.Logistic regression analysis was used for multi-factor analysis.The difference in p<0.05 was statistically significant.Results1.A total of 79 questionnaires were sent out,71 valid questionnaires were collected,and the recovery efficiency was 89.95%.2.71 patients were included in this study,including 49 male ones and 22female ones with the average age of(77.06±10.403).Thereinto,67 elderly patients were over 60 years old,accounting for 94.37%.68 patients retired and 3 patients were on the job,with the retired ones accounting for 95.77%.As for marital status,52 patients were married accounting for 73.24%,and19 ones were unmarried,accounting for 26.76%.The education level was dominated by illiteracy and primary school and middle school levels,respectively accounting for 18.3%and 52.1%.Their monthly household income was mainly 4000-6999 yuan/month and 7000-9999 yuan/month,with the same proportion of 32.4%.In the aspect of medical insurance,50patients had urban medical insurance,with the maximum proportion of70.4%.There were 39 patients receiving the comprehensive assessment of COPD in Group D,with the maximum proportion of 54.9%.3.The median of annual economic burden of disease for patients receiving pulmonary rehabilitation is 16,369.71 yuan,with direct economic burden of 10,794.31yuan,accounting for 73.69%,and indirect economic burden of 8,690yuan,accounting for 26.31%.4.The economic burden of pulmonary rehabilitation is related to comprehensive assessment grouping of COPD,type of medical insurance,sports therapy,expectoration training and noninvasive ventilation and oxygen therapy(P<0.05).The economic burden of pulmonary rehabilitation is not significantly correlated with gender,age,marital status,education level,monthly household income,exposure history of dust,gas and smoke,history of smoking,respiratory training,nutritional support,psychological treatment,guidance of self-management approaches,and vaccination situation of influenza vaccine and pneumococcal vaccine in the past year(P>0.05).5.After including the notable factors of single-factor analysis into the multiple-factor regression analysis of Logistics and excluding all interference factors,it can be obtained that the comprehensive assessment grouping of COPD is an independent influence factor for economic burden of pulmonary rehabilitation(OR=2.937,95%CI:1.801-4.790,P<0.05).The higher the level of COPD assessment is,the heavier the economic burden of patients in pulmonary rehabilitation will be.Conclusions1.The economic burden of pulmonary rehabilitation of COPD patients is heavy,the higher the grade of comprehensive assessment of COPD,the heavier the economic burden of pulmonary rehabilitation.Reduce AECOPD and delaying the disease progression is the major measure to control COPD patients' economic burden in pulmonary rehabilitation.2.It is necessary to add relevant evidences for the economic cost of pulmonary rehabilitation so as to compare researches of the same type.Discuss the pulmonary rehabilitation program that is affordable for COPD patients with cost effectiveness to relieve the economic burden of disease for COPD patients. |
PDF Full Text Request