中国城市 COPD 患者的生活质量及其与直接医疗费用的相关性。
Quality of life and its association with direct medical costs for COPD in urban China.
机构信息
School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China.
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
出版信息
Health Qual Life Outcomes. 2015 May 14;13:57. doi: 10.1186/s12955-015-0241-5.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Few studies have focused on the quality of life (QoL) associated medical costs for COPD in China.
METHODS
A cross-sectional survey of 678 COPD patients was conducted in four major cities (Beijing, Shanghai, Guangzhou and Chengdu), China, in 2011. Data on socio-demographic information, health conditions and medical costs were collected through a face-to-face interview combined with medical record searching. The EuroQol (EQ-5D) health questionnaire was applied to assess the QoL of COPD patients.
RESULTS
Among 678 patients with COPD, nearly 40% had difficulties in mobility, usual activities and pain/discomfort, one third had various degrees of anxiety/depression, and one fifth had difficulties in self-care. The COPD patients had a median utility score of 0.768 and a median visual analog scale score of 70. The degree of difficulties in any dimensions significantly increased, and utility and health scores decreased with severity of the disease. Age, gender and disease severity were significantly associated with the quality of life after taking other covariates into consideration. Poorer QoL was a significant indicator of higher direct medical costs for COPD patients.
CONCLUSION
Impaired quality of life was significantly linked to increased medical costs for COPD patients and could be an important measure for policy- and decision-making in COPD care.
背景
慢性阻塞性肺疾病（COPD）是全球主要死因之一。在中国，很少有研究关注 COPD 相关医疗费用的生活质量（QoL）。
方法
2011 年在中国四个主要城市（北京、上海、广州和成都）进行了一项 COPD 患者的横断面调查。通过面对面访谈结合病历检索收集了社会人口统计学信息、健康状况和医疗费用数据。采用欧洲五维健康量表（EQ-5D）健康问卷评估 COPD 患者的 QoL。
结果
在 678 例 COPD 患者中，近 40%的患者在移动、日常活动和疼痛/不适方面存在困难，三分之一的患者有不同程度的焦虑/抑郁，五分之一的患者在自我护理方面存在困难。COPD 患者的平均效用评分为 0.768，平均视觉模拟评分（VAS）为 70。各维度的困难程度显著增加，随着疾病严重程度的增加，效用和健康评分降低。在考虑其他协变量后，年龄、性别和疾病严重程度与生活质量显著相关。生活质量较差是 COPD 患者医疗费用增加的一个显著指标。
结论
生活质量受损与 COPD 患者医疗费用的增加显著相关，可能是 COPD 护理政策和决策的重要衡量标准。
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