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评估印度南部城市哮喘和慢性阻塞性肺疾病患者的求医行为。

Assessing health-seeking behavior among Asthma and COPD patients in urban South India.

作者信息

Arjun Padmanabhan, Nair Sanjeev, Jilisha G, Anand Jyolsna, Babu Veena, Moosan Hisham, Kumari Anitha K

机构信息

Health Action by People and SP Fort Hospital, Trivandrum, India.

Health Action by People and Department of Pulmonary Medicine, Medical College, Trivandrum, India.

出版信息

J Family Med Prim Care. 2019 Aug 28;8(8):2714-2719. doi: 10.4103/jfmpc.jfmpc_485_19. eCollection 2019 Aug.

Abstract

CONTEXT

Health-seeking behavior of patients with chronic obstructive pulmonary disease (COPD) and asthma and the diagnosis told to them by doctors before they reach tertiary care is not well documented.

AIMS

This study aimed at describing the health-seeking behavior of asthma and COPD patients before they present to a tertiary care hospital in Trivandrum in South India.

METHODS AND MATERIALS

The hospital-based cross-sectional study was done at one government and one private tertiary care hospital in Trivandrum, Kerala, including diagnosed COPD and asthma patients. Data were collected using a pretested semistructured questionnaire paired with the results of clinical evaluation and spirometry.

RESULTS

Among the studied population, about half (53%) of the patients in this study sought initial treatment from government facilities and most patients continued the same pattern of government care or private providers till the final level. Most of them (91%) were likely to have a history of first care from modern medicine system. High proportion of patients (89%) did not have a diagnosis known after the initial consultations, among patients with asthma only 3.4% were given a correct diagnosis and only one person was given a correct diagnosis of COPD out of 129 patients with COPD as the final diagnosis. Out of 739 patients, only 135 patients had done pulmonary functtion test as investigation.

CONCLUSIONS

High proportions of patients do not know the diagnosis of their disease when they reached tertiary care. Patients tended to follow the same sector of health care (private/government) where they sought initial care.

摘要

背景

慢性阻塞性肺疾病(COPD)和哮喘患者的就医行为以及他们在接受三级医疗服务之前医生告知他们的诊断情况,目前尚无充分记录。

目的

本研究旨在描述印度南部特里凡得琅一家三级医院的哮喘和慢性阻塞性肺疾病患者在就诊前的就医行为。

方法和材料

在喀拉拉邦特里凡得琅的一家政府和一家私立三级医院进行了一项基于医院的横断面研究,纳入已确诊的慢性阻塞性肺疾病和哮喘患者。通过使用预先测试的半结构化问卷收集数据,并结合临床评估和肺活量测定结果。

结果

在研究人群中,本研究约一半(53%)的患者最初在政府医疗机构寻求治疗,大多数患者在最终阶段之前继续接受相同模式的政府医疗或私人医疗服务。他们中的大多数(91%)可能有现代医学系统的首次就医史。在初次咨询后,很大比例的患者(89%)不知道诊断结果,在哮喘患者中只有3.4%得到了正确诊断,在最终诊断为慢性阻塞性肺疾病的129名患者中,只有1人得到了正确诊断。在739名患者中,只有135名患者进行了肺功能测试作为检查。

结论

很大比例的患者在接受三级医疗服务时不知道自己的疾病诊断。患者倾向于在他们最初寻求治疗的同一医疗保健部门(私立/政府)接受后续治疗。

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