Analysis Of Prevalence And Socio-Economic Burden Of Cardiovascular Diseases In Rural Guan Du District Of Kunming

OBJECTIVE This study estimated the prevalence and socio-economic burden of cardiovascular diseases(CVD) in rural Guan Du district of Kunming based on a cross-sectional health examination survey conducted in 2009,and measured the direct, indirect and intangible economic burden of CVD and influencing factors.The results could serve as a basis to provide evidence for the local government to prevent and control CVD,and to reduce the economic burden of CVD effectively.METHODS Guan Du distrct was selected as the study community.It consisted of 9 townships.Three villages was chosen based on the probability proportional to size (PPS) from each township.In each selected village,we obtained a name list of individuals aged＞18 years from the village committee,and simple random sampling was used to select 150 individuals from each village.Information was obtained from a cross-sectional questionnaire survey.Two-steps method was used to measure direct economic burden of CVD,indirect economic burden of CVD was calculated by disability adjusted life years(DALY) combined with human capita method,and intangible economic burden was estimated by willingness to pay method.Multiple linear regression was applied to analyze possible influencing factors of economic burden of hypertension,stroke and ischemic heart disease(IHD).Data analyses were done with SPSS software version 15.0.RESULTS 4011 parpicipants consented to participate in the survey,with a response rate of 98.5%.The overall prevalence of hypertension,stroke and IHD was 33.9%, 1.3%and 3.1%,respectively.Among males,the prevalence of hypertension,stroke and IHD was 34.8%,1.5%and 3.5%,whereas was 33.4%,1.1%and 3.1%for females. There was no significant difference of prevalence of hypertension,stroke and IHD between men and women(p＞0.05).For all three diseases,the prevalence increased with age,and the older age group people had obviously higher prevalence than younger age group people.Smokers had higher prevalence of hypertension than non-smokers(p＜0.01).Drinkers had higher prevalence of hypertension,stroke and IHD than non-drinkers(p＜0.01).Overweight individuals and obese people had higher prevalence of hypertension,stroke and IHD than non-overweight individuals and non-obese people(p＜0.05).The prevalence of hypertension was greater in individuals with family history of diabetes and hypertension than in those without family history of diabetes and hypertension(p＜0.05),and the prevalence of IHD was greater in individuals with family history of heart disease and high cholesterol than in thosewithout family history of heart disease and high cholesterol(p＜0.05). Individuals with family history of stroke had higher prevalence of stroke than those without family history of stroke(p＜0.05).The per 1000 population DALY for hypertension,stroke and IHD was 4.6(3.7 for males and 5.1 for females),39.3(43.4 for males and 34.1 for females) and 34.0(37.0 for males and 28.6 for females),respectively.Stroke is most serious for people's health among three diseases.Stroke and IHD were more harmful for people's health among males than that of among females.In the study region,the per capita socio-economic burden of hypertension,stroke and IHD was 5184.8 Yuan(5338.5 Yuan for men and 5126.2 Yuan for women), 18511.7 Yuan(15531.9 Yuan for men and 20778.9 Yuan for women) and 12877.4 Yuan(14912.4 Yuan for men and 11554.7 Yuan for women),respectively.The per capita direct,indirect and intangible economic burden of hypertension was 2939.8Yuan,313.3 Yuan and 2851.0 Yuan,respectively,whereas was 8971.9Yuan, 2915.2Yuan and 8220.0 Yuan for stroke,and 7690.8 Yuan,1209.2 Yuan and 5399.0 Yuan for IHD,respectively.The total socio-economic burden of hypertension,stroke and IHD was 237,228,100,0 Yuan,324,806,000 Yuan and 573,557,000 Yuan. Stroke accounted for the highest per capia direct,indirect and intangible economic burden among three diseases.Patients with longer length of hospital stay and patients suffered from hypertension,stroke and IHD which had worse effect on household works had higher probability of having higher direct economic burden of hypertension,stroke and IHD. Furthermore,patients stayed in higher level hospital and patients with lower ability to pay had higher probability of having higher direct economic burden of hypertension and stroke.Patients with higher educational level and higher income had higher probability of having higher intangible economic burden of hypertension and IHD. Male patients and patients with higher ability to pay had higher probability of having higher intangibel economic burden of stroke.Conclusion CVD have been the major diseases for influencing rural residents' health in the study region,especially for stroke.Enhancing health promotion of quitting smoking and drinking,and reducing the prevalence of overweight and central obesity are helpful to reduce the prevalence of cardiovascular diseases.The rural residents have suffered from heavy economic burden of hypertension,stroke and IHD in the study region.The findings suggest that improving the hospital management level and work efficiency,reducing patient's length of stay are effective strategies to reduce the economic burden of CVD.