To survey the under-using status of spirometry in rural community and assess its impact on the missed diagnosis of chronic obstructive pulmonary disease (COPD).

A total of 708 participants aged 60 years or more were sampled by cluster random sampling from 4 administrative villages in Qiaozi, Huairou, Beijing in this cross-sectional study. Questionnaire survey and spirometry were performed to each person. Patients with FEV₁/FVC<70% were further diagnosed as COPD.

96 patients were diagnosed as COPD and the rude prevalence of COPD was 13.56%(95%CI: 11.04%-14.08%) among elder people aged 60 years or more in rural community. However, only 8 of 96 patients with COPD (8.33%) have been acquired spirometry. Among 708 participants, only 34 patients (4.80%) have been checked by spirometry. The multivariate logistic regression analysis was conducted to explore the potential cause of taking spirometry which showed patients with bronchitis were more inclined to seek spirometry (OR: 5.39; its 95%CI: 2.20-13.19). The results of multivariate logistic regression analysis to explore the potential diagnostic indices of COPD showed age, smoking (the cumulative amount was more than 100 cigarettes or 5 packages) and wheezing was statistically significant.

The underuse of spirometry in rural community of China results in the missed diagnosis of COPD in community. It was suggested that general practitioners should advise the elderly smokers with wheezing to acquire spirometry in the community timely or referral to hospital so that patients with COPD could be diagnosed earlier and be managed.

Pulmonary disease, chronic obstructive; Respiratory function tests; Rural Health services; Cross-sectional study