Pharmacy Administration and Public Health, University of Houston, Houston, TX, USA ; US Health Outcomes, GlaxoSmithKline, Durham, NC, USA.
US Health Outcomes, GlaxoSmithKline, Durham, NC, USA.
Int J Chron Obstruct Pulmon Dis. 2014 Mar 19;9:289-300. doi: 10.2147/COPD.S57157. eCollection 2014.
To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD) in the US.
Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality.
Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987-2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%-18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27-63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3-19.4 days. Estimates of bed confinement range from 13-32 days per year. Estimated mean annual indirect costs were $893-$2,234/person (US dollars) with COPD ($1,521-$3,348 in 2010 [US dollars]) and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect) costs, indirect costs accounted for 27%-61% of total costs, depending on the population studied.
COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability. Consideration of indirect as well as direct costs is necessary to gain a more complete view of the societal burden of COPD.
综述和总结美国慢性阻塞性肺疾病（COPD）间接负担的现有文献。
使用定义的检索词在 Medline、Scopus 和 OvidSP 数据库中进行检索，以确定相关研究。合格的研究发表于 2000 年 1 月至 2012 年 4 月之间，以流行率、发病率或生产力损失、残疾、发病或死亡率的成本的形式计算了美国人群中 COPD 的间接负担。
在确定的 53 项研究中，有 11 项符合入选标准，数据年限跨越 1987-2009 年。COPD 患者的劳动力参与率估计范围为 56%-69%，无 COPD 患者为 65%-77%。大约 13%-18%的 COPD 患者的工作数量或类型受到限制，三分之一或更多的人经历了一般活动受限。受限活动天数的估计范围为每年 27-63 天。估计患有 COPD 的在职人员的平均每年病假和/或残疾天数为 1.3-19.4 天。估计每年卧床时间范围为 13-32 天。估计患有 COPD 的个人的平均每年间接费用为 893-2234 美元（美元）（2010 年为 1521-3348 美元），具体取决于研究人群、特定成本结果和经济投入。在评估总（直接和间接）成本的研究中，间接成本占总费用的 27%-61%，具体取决于研究人群。
COPD 与大量间接费用相关。该疾病给雇主带来生产力损失和相关成本的负担，并给个人带来与旷工、活动受限和残疾相关的收入损失的负担。考虑间接和直接成本对于更全面地了解 COPD 的社会负担是必要的。
