Follow-up study on management of chronic obstructive pulmonary disease in Hunan Province, the People’s Republic of China

Figures & data

Table 1 Baseline characteristics of public hospitals (PHs) and pulmonologists

Variable	Total		Third-level PHs		Second-level PHs		First-level PHs
	2009	2013	2009	2013	2009	2013	2009	2013
PHs (n)	57	48	15	15	24	24	18	9
Pulmonologists (n)	846	762	192	204	559	506	95	52
Pulmonologists’ educational level (n)
High	82	109	73	93	9	16	0	0
Medium	604	520	117	111	424	380	63	29
Low	160	133	2	0	126	110	32	23
Pulmonologists’ professional level (n)
Senior	115	124	40	45	55	67	20	12
Intermediate	378	332	100	98	244	205	34	29
Junior	353	306	52	61	260	234	41	11

Notes: Pulmonologists’ educational level was categorized into three levels: high educational level means PhD and master’s degree of medicine, median means bachelor’s degree of medicine, and low indicates someone who had just completed junior medical college or medical school. Pulmonologists’ professional level was categorized into three levels: senior title implies deputy chief physician or chief physician, intermediate title implies attending physician, and junior title implies resident physician.

Table 2 Allocation of COPD-related health resources in three levels of public hospitals (PHs) in 2009 and 2013

Allocation of resources (%)	Total		Third-level PHs		Second-level PHs		First-level PHs
	2009	2013	2009	2013	2009	2013	2009	2013
	(n=57)	(n=48)	(n=15)	(n=15)	(n=24)	(n=24)	(n=18)	(n=9)
Spirometers	40	69*	100	100	33	75*	0	0
Inhalation agents	58	88*	100	100	71	100*	6	33
COPD-related health care education	35	63*	67	87	42	63	0	22

Notes:

* Chi-square test was used to compare in 2009 and 2013, P<0.05.

Table 3 Accuracy rate (AR) of every question of physicians in three levels of public hospitals (PHs) in 2013

Questionnaire	AR (%)
	Third-level PHs (n=204)	Second-level PHs (n=506)	First-level PHs (n=52)
1. Hallmark symptom of COPD	86*	55*	40*
2. Pathogen of COPD	97*	83*	65*
3. Criteria of airflow limitation	91*	48*	21*
4. Diagnostic tools of COPD	100*	47*	40
5. Grading criteria of COPD	83*	43*	23*
6. Medicine of COPD	91*	65*	27*
7. Oxygen therapy of COPD	81*	51*	31*
8. Treatment of COPD	90*	66*	29*
9. Acute exacerbation cause of COPD	98*	93*	79*
10. Indication of noninvasive venation	83*	56*	40*

Notes:

* Chi-square test was used to compare between any of the two groups, P<0.05.

Figure 1 Scores of COPD knowledge questionnaire based on educational levels of different pulmonologists in 2013.

Figure 2 Scores of COPD knowledge questionnaire based on professional titles of different pulmonologists in 2013.

Table 4 Accuracy rate (AR) of every question of physicians between the control group and the intervention group in six second-level PHs

Questionnaire	AR (%)		P-value
	Control group	Intervention group
	(n=126)	(n=78)
1. Hallmark symptom of COPD	60	94	<0.001*
2. Pathogen of COPD	62	90	<0.001*
3. Criteria of airflow limitation	41	63	0.002*
4. Diagnostic tools of COPD	60	77	0.018*
5. Grading criteria of COPD	44	63	0.01*
6. Medicine of COPD	52	87	<0.001*
7. Oxygen therapy of COPD	40	62	0.002*
8. Treatment of COPD	57	88	<0.001*
9. Acute exacerbation cause of COPD	86	94	0.08
10. Indication of noninvasive venation	45	60	0.04*

Notes:

* Chi-square test was used to compare between the control group and the intervention group, P<0.05.

Abbreviation: PHs, public hospitals.

Table 5 Doubtful diagnosis and diagnosis ratio of COPD between the control group and the intervention group during three periods in six second-level PHs

Groups	Before intervention			During intervention			Follow-up visit
	n	Doubtful diagnosis	Diagnosis	n	Doubtful diagnosis	Diagnosis	n	Doubtful diagnosis	Diagnosis
Control group	3,322	1%	0%	2,990	1%	0%	4,331	4%	1%
Intervention group	2,867	1%	0%	2,930	14%	3%	4,136	15%	3%
χ^2		0.43			404.02	86.95		303.44	79.50
P-value		0.51			<0.001	<0.001		<0.001	<0.001

Abbreviation: PHs, public hospitals.