Treatment patterns for chronic obstructive pulmonary disease under the tiered medical system

Abstract China has implemented the “tiered medical services” policy since 2015, while there is a paucity of data evaluating the the current status of chronic obstructive pulmonary disease (COPD) management under the system. Characteristics and treatments from 11,905 COPD patients in 88 hospitals across different tiers in China were included and analyzed. We assessed the statistical significance of differences by one way analysis of variance (ANOVA) for continuous variables and with the chi-squared test for categorical variables. Patients in primary hospitals (Tier1) exhibited heightened exposure to risk factors including smoking, household biofuel, and family history of respiratory diseases, and displayed elevated COPD assessment test (CAT) and modified Medical Research Council (mMRC) dyspnea scale scores, and worse lung function, in comparison to tertiary (Tier3) hospitals (P