Department of Respiratory Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, C/Doctor Esquerdo 46, 28007, Madrid, Spain,
Lung. 2015 Feb;193(1):53-62. doi: 10.1007/s00408-014-9682-6. Epub 2014 Dec 31.
Chronic obstructive pulmonary disease (COPD) patients often have a significant impairment in their health status, which is an independent predictor of health services use.
To describe the self-rated health status and the prevalence of health services use among COPD Spanish patients; to identify which factors are independently associated with a worse health status and a higher use of health services; and to study the time trends in the health status and prevalence of use of health services (2006-2012).
Observational study: We analyzed data from the Spanish National Health Surveys conducted in 2006 and 2012. We included responses from adults aged 40 years or over. Subjects described their health status as very good, good, fair, poor, or very poor, which was dichotomized into very good/good or fair/poor/very poor self-perceived health status.
We identified 2,321 COPD patients. The percentage of patients with health status fair, poor, or very poor was 76.8 % in 2006 and 74.8 % in 2012 (p > 0.05). Regarding the health resources use, we observed a significant decrease in the number of visits to primary care over time in women (67.8 vs. 57.2 %, p < 0.05) and men (62.2 vs. 54.0 %, p < 0.05). However, we did not find improvement in the prevalence of emergency department visits or hospitalizations. Associated factors with a worse self-rated health status and a higher use of health services in women and men included: having three or more chronic diseases, presence of mental disorders, and absence of leisure time physical activity.
The current study revealed a decrease in the general practitioner visits, without changes in use of other health care services in the COPD Spanish population from 2006 to 2012. The self-rated health status did not changed significantly during this period.
慢性阻塞性肺疾病（COPD）患者的健康状况往往显著受损，这是健康服务利用的独立预测因素。
描述西班牙 COPD 患者的自我评估健康状况和健康服务利用的流行情况；确定哪些因素与较差的健康状况和更高的健康服务利用独立相关；并研究健康状况和健康服务利用的流行趋势（2006-2012 年）。
观察性研究：我们分析了 2006 年和 2012 年进行的西班牙国家健康调查的数据。我们纳入了年龄在 40 岁及以上的成年人的回复。受试者将自己的健康状况描述为非常好、好、一般、差或非常差，将其分为非常好/好或一般/差/非常差的自我感知健康状况。
我们确定了 2321 例 COPD 患者。2006 年和 2012 年，健康状况一般、差或非常差的患者比例分别为 76.8%和 74.8%（p>0.05）。关于健康资源的利用，我们观察到女性（67.8%比 57.2%，p<0.05）和男性（62.2%比 54.0%，p<0.05）的初级保健就诊次数随时间显著减少。然而，我们没有发现急诊就诊或住院的比例有所改善。女性和男性中与自我评估健康状况较差和健康服务利用较高相关的因素包括：患有三种或更多种慢性病、存在精神障碍以及缺乏闲暇时间的体育活动。
本研究显示，2006 年至 2012 年期间，西班牙 COPD 人群的全科医生就诊次数减少，但其他卫生保健服务的利用没有变化。在此期间，自我评估的健康状况没有显著变化。
