Precision Health Economics, Los Angeles, CA, USA.
COPD. 2012 Aug;9(5):513-21. doi: 10.3109/15412555.2012.696159. Epub 2012 Jun 21.
Affecting an estimated 12.6 million people and causing over 100,000 deaths per year, chronic obstructive pulmonary disease (COPD) exacts a heavy burden on American society. Despite knowledge of the impact of COPD on morbidity, mortality, and health care costs, little is known about the association of the disease with economic outcomes such as employment and the collection of disability. We quantify the impact of COPD on Americans aged 51 and older-in particular, their employment prospects and their likelihood of collecting federal disability benefits-by conducting longitudinal regression analysis using the Health and Retirement Study. Controlling for initial health status and a variety of sociodemographic factors, we find that COPD is associated with a decrease in the likelihood of employment of 8.6 percentage points (OR = 0.58, 95% CI 0.50-0.67), from 44% to 35%. This association rivals that of stroke and is larger than those of heart disease, cancer, hypertension, and diabetes. Furthermore, COPD is associated with a 3.9 percentage point (OR 2.52, 95% CI 2.00-3.17) increase in the likelihood of collecting Social Security Disability Insurance (SSDI), from 3.2% to 7.1%, as well as a 1.7 percentage point (OR 2.87, 95% CI 2.02-4.08) increase in the likelihood of collecting Supplemental Security Income (SSI), from 1.0% to 2.7%. The associations of COPD with SSDI and SSI are the largest of any of the conditions studied. Our results are consistent with the hypothesis that COPD imposes a substantial burden on American society by inhibiting employment and creating disability.
慢性阻塞性肺疾病（COPD）影响估计有 1260 万人，每年导致超过 10 万人死亡，给美国社会带来了沉重负担。尽管人们已经了解 COPD 对发病率、死亡率和医疗保健成本的影响，但对于该疾病与就业和残疾津贴等经济结果的关联知之甚少。我们通过使用健康与退休研究进行纵向回归分析，量化了 COPD 对 51 岁及以上美国人的影响——特别是他们的就业前景和获得联邦残疾津贴的可能性。在控制初始健康状况和各种社会人口因素后，我们发现 COPD 使就业的可能性降低了 8.6 个百分点（OR=0.58，95%CI 0.50-0.67），从 44%降至 35%。这种关联可与中风相媲美，大于心脏病、癌症、高血压和糖尿病的关联。此外，COPD 使获得社会保障残疾保险（SSDI）的可能性增加了 3.9 个百分点（OR 2.52，95%CI 2.00-3.17），从 3.2%增加到 7.1%，同时使获得补充保障收入（SSI）的可能性增加了 1.7 个百分点（OR 2.87，95%CI 2.02-4.08），从 1.0%增加到 2.7%。COPD 与 SSDI 和 SSI 的关联是所有研究疾病中最大的。我们的结果与以下假设一致，即 COPD 通过抑制就业和造成残疾，给美国社会带来了巨大负担。
