目前,新型农村合作医疗正在我国300多个县(市)开展试点工作.然而,在农村总体经济实力不强又面临市场经济冲击的大形势下,建立新型农村合作医疗制度将是一项十分艰难、复杂的工程.本文讨论了新型农村合作医疗制度产生的历史背景及如何增强农民对新型农村合作医疗制度的信心问题.
ObjectiveTo retrospectively collect data on patients with stable chronic obstructive pulmonary disease (COPD), and explore the current status of medication adherence and its main influencing factors in China.MethodsAccording to the principle of convenience, 293 patients with COPD were enrolled in 16 tertiary hospitals located in Nanjing, Hefei, Wuhu, Xuzhou, and Chuzhou. The status quo and influencing factors of medication adherence in COPD patients were identified and analyzed by using the 8-item Morisky Drug Compliance Scale, Beliefs about Medicines Questionnaire, Hospital Anxiety and Depression Scale, General Self-Efficacy Scale, and modified British Medical Research Council. The analysis was based on the framework provided by the WHO’s "five-dimensional determinants" and the mathematical relationship was demonstrated through sequential logistic regression analysis. ResultsThe medication adherence of the target population is 11.95%. A higher socio-economic status [odds ratio (OR) 0.30, 95% confidential interval (CI) 0.10 - 0.91], patients’ general beliefs about the medication utility (OR 0.29, 95%CI 0.17 - 0.50) and overuse (OR 0.30, 95%CI 0.16 - 0.55) were associated with a lower chance of being adherent in patients with COPD. While disease severity (OR 2.01, 95%CI 1.11 - 3.64) and types of drug use (OR 1.91, 95%CI 1.07 - 3.41) presented opposite results. ConclusionsMedication adherence in domestic patients with COPD is not satisfactory at the present stage. Effective ways to improve patients’ medication adherence and quality of life could be proposed from the national, living environment and individual three dimensions.