Status quo of chronic obstructive pulmonary disease management in primary care health institutions of Beijing Miyun District after the Measures to Improve Medical Services in Primary Medical and Health Institutions / 中华全科医师杂志

ABSTRACT

Objective:To investigate the status quo of the management of chronic obstructive pulmonary disease (COPD) in primary care health institutions in Miyun District of Beijing.Methods:The Measures to Improve Medical Services in Primary Medical and Health Institutions was issued by Beijing Municipal Health Commission in June 2019. In August 2020, a survey on COPD management status after the measures was conducted with self-designed questionnaire among 19 community health service centers and 61 general practitioners (GPs) from 4 centers in Miyun District of Beijing. Two questionnaires were used for the survey one was on the status of medical institutions (institution questionnaire, filled by the person in charge of the center) and other was on COPD knowledge of general practitioners (doctor questionnaire, filled by selected GPs). Results:For health institution, 19 valid questionnaires were collected. Among them, 12 centers were equipped with lung function examination equipment after reform; 17 centers were equipped with inhaled corticosteroids/long acting β 2 receptor agonists (ICS/LABA); 12 centers carried out the contract management of family doctors for COPD; 267 patients signed the contract, 7 centers followed up the signed patients at least twice a year; 13 centers referred patients to Miyun District Hospital with 2 024 referrals per year. For GPs, 61 valid questionnaire were collected with a recovery rate of 100% (61/61). Among them 12 GPs (20%) had contracted management for COPD patients; 12 GPs (20%) had referred COPD patients to the secondary or tertiary hospitals; and 9/12 of GPs referred the patients for lung function examination due to the needs of diagnosis or follow-up.The mean COPD-related knowledge score was (58.9±20.0), compared with the score of 65 GPs from the 4 same community centers tested in 2018 (63.2±18.9), there was no significant difference ( t=0.456, P>0.05). Conclusions:The implementation of the primary care institution measures in Beijing promoted the management of COPD and improved capacity building in primary health institutions, also promoted the work docking between primary health institutions and secondary, tertiary hospitals. However, it is still necessary to strengthen the ability training of general practitioners in relevant knowledge and skills to improve their management ability of COPD.