Analysis of Medical Seeking Behavior and Influencing Factors in Patients With Chronic Obstructive Pulmonary Disease

Abstract Purpose: To explore the status of medical seeking behavior in patients with chronic obstructive pulmonary disease (COPD), and clarify relevant factors that may affect the diagnosis delay. Methods: A cross-sectional study was conducted in a Chinese tertiary hospital from July 2019 to February 2020. A total of 408 eligible outpatient COPD patients were recruited and relevant data were collected in the form of questionnaire. Diagnosis delay was compared among different characteristics using Wilcoxon test and Kruskal-Wallis H test. Correlation analysis were performed to further explore factors related to diagnosis delay. Results: The median (interquartile range [IQR]) duration of diagnosis delay was 230 (50 - 720) days. Proportions of COPD patients who chose tertiary hospitals, secondary hospitals, and first – level hospitals for the first visit were respectively 53.7%, 29.9% and 16.4%. Additionally, proportions of patients who received pulmonary function test for the first visit in tertiary hospitals, secondary hospitals, and first – level hospitals were namely, 83.9%, 15.5%, and 1.5% (p < 0.001). In terms of characteristics related to diagnosis delay, there is a significant difference in residence, resident manner, CAT , mMRC, age, FEV1% predicted, years of education, average family income(p < 0.001). Furthermore, diagnosis delay is correlated with patients’ knowledge level of COPD and other characteristic variables (including age, years of education, resident manner, average family income, CAT , mMRC, FEV1% predicted, and FEV1/FVC) to varying degrees. Conclusion: Our study indicates that varying degrees of diagnosis delay may exist in COPD patients. Measures are needed to intervene potential factors related to diagnosis delay.