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Assessing Quality of Life and the Burden of Disease in Patients with Chronic Disease in Rural China

Author: DongZuoQiu
Tutor: ChenJiaYing
School: Nanjing Medical University
Course: Social Medicine and Health Management
Keywords: EQ-5D health related quality of life burden of disease priority intervention
CLC: R195
Type: Master's thesis
Year: 2012
Downloads: 378
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Objective:Through the description and analysis of the prevalence of chronic diseases in ruralChina, evaluation of the quality of life and the burden in patients with chronicdiseases, this paper shows that priority intervention of chronic disease can reducethe loss of quality and burden of disease brought about by chronic disease. In order toachieve the purpose of rational allocation of limited health resources,communityintervention model to explore for the country in rural areas with chronic disease andthe development of chronic disease management policy, this paper also does researchon such aspects.Methods:Measurement system including an intuitive health scale VAS and the EQ-5D scale offive dimensions to carry out the measurement and analysis of the life quality of ruralpatients with chronic disease. Using QALYs to reflect the burden of chronic diseasepatients, which is calculated by the life quality relative weight based on thepopulation. The priority of intervention disease is decided by BPR and expert advicescore, which is the ranking of chronic disease in rural areas.Results:(1) The test consistency reliability and validity of EQ-5D scale are good for thissurvey research.(2) In the investigation of a total population of80,070people, the number of patientswith chronic disease self-report within six months of15,683cases,chronic totalprevalence rate is19.6%. The prevalence is changing in different region, gender and age. According to the constitution level of chronic disease in rural areas, this paperuses the top50chronic disease, which are made up of diseases circulatory system,digestive system diseases, musculoskeletal system, respiratory system diseases,genitourinary system diseases, cancer and so on.(3) Totally, chronic disease decreases the life quality of patients. In the west region ofour country, the quality of life of patients with chronic disease is the worst, however,reduction in chronic disease quality of life is most obvious in the central region. Theimpact of chronic disease on women’s quality of life is mainly reflected in thephysiological aspects, while the impact of chronic disease on men’s quality of lifeis mainly reflected in psychological aspects. The quality of life of the elderlypopulation with chronic disease in rural areas is much worse judging from theabsolute valve, however, the reduction of quality of life caused by chronic disease isbigger in relative young people.(4) The average remaining health time is38.84years, in the sampling area. Hepaticmalignancy remaining QALYs per capita loss is up to72.84%.The loss of remainingQALYs caused by salpingitis and oophoritis is the least. Known by the diseasesoverall, remaining QALYs losser per capita up to the top three are the digestivesystem malignancies. Disease of the reproductive system influences much more onthe life quality of male.(5) The credibility of the results of the consultation is considerably high because ofthe expert advisory experts in a positive coefficient and the higher authority of thecoefficient. Hypertension, nutritional deficiencies and diabetes are the top threechronic disease which can be intervened sufficiently. According the ranking of BPR,hypertension, diabetes and cerebrovascular diseases are on the top of the list. And inthe top20, there are four kinds of malignant tumors. Meanwhile, benign prostatichyperplasia or inflammation and cervical cancer are also on the list. Conclusion:(1) Chronic disease can cause the reduction of the quality of life.Medical centershould focus on the health of the young, female and patients from the central region.Emphasis should also be put on the influence to quality of life caused by economicaland environmental policies. Public guidance of the prevention and treatment ofchronic disease should be carried out actively in order to improve theself-management and awareness ability of rural people.(2) Chronic disease will bring heavy burden of disease, so strengthening the screeningand diagnosis of cancer and male reproductive system diseases should be focused on.Meanwhile, standardized management of chronic disease should be carried outactively in order to ease the psychological risks and reduce the negative impact ofchronic disease.(3) Selection of the priority of chronic disease is a very important way to allocatingmedical source rationally and improving the efficiency of source usage. Hypertension,diabetes, cerebrovascular disease and diseases like these should be intervened firstly,meanwhile, the sight on malnutrition or lack,malignant tumors and chronic disease ofthe reproductive system should be strengthened. This paper advices that malnutritionor lack and the male reproductive system disease should be included in the basicpublic health servives. With more attention,early detection,early diagnosis,earlytreatment, the life quality of patients with chronic disease can be improved and theburden of disease can be reduced.

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