College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
College of Medicine, University of Kentucky, Lexington, KY, USA.
Int J Chron Obstruct Pulmon Dis. 2024 May 13;19:1033-1046. doi: 10.2147/COPD.S446696. eCollection 2024.
Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with reduced life expectancy, increased morbidity, mortality, and cost. This study characterized the US COPD burden, including socioeconomic and health-related quality of life (HRQoL) outcomes.
In this retrospective, cross-sectional study using nationally representative estimates from Medical Expenditures Survey (MEPS) data (2016-2019), adults (≥18 years) living with and without COPD were identified. Adults living without COPD (control cohort) and with COPD were matched 5:1 on age, sex, geographic region, and entry year. Demographics, clinical characteristics, socioeconomic, and generic HRQoL measures were examined to include a race-stratified analysis of people living with COPD.
A total of 4,135 people living with COPD were identified; the matched dataset represented a weighted non-institutionalized population of 11.3 million with and 54.2 million people without COPD. Among people living with COPD, 66.3% had ≥1 COPD-related condition; 62.7% had ≥1 cardiovascular condition, compared to 33.5% and 50.5% without COPD. More people living with COPD were unemployed (56.2% vs 45.3%), unable to work due to illness/disability (30.1% vs 12.1%), had problems paying bills (16.1% vs 8.8%), reported poorer perceived health (fair/poor: 36.2% vs 14.4%), missed more working days due to illness/injury per year (median, 2.5 days vs 0.0 days), and had limitations in physical functioning (40.1% vs 19.4%) (all <0.0001). In race-stratified analyses for people living with COPD, people self-reporting as Black had higher prevalence of cardiovascular-risk conditions, poorer socioeconomic and HRQoL outcomes, and higher healthcare expenses than White or Other races.
Adults living with COPD had higher clinical disease burden, lower socioeconomic status, and reduced HRQoL than those without, with greater disparities among Black people living with COPD compared to White and other races. Understanding the characteristics of patients helps address care disparities and access challenges.
慢性阻塞性肺疾病（COPD）是一种与预期寿命缩短、发病率和死亡率增加以及医疗费用增加相关的进行性疾病。本研究描述了美国 COPD 的负担，包括社会经济和健康相关生活质量（HRQoL）结果。
本研究使用来自医疗支出调查（MEPS）数据（2016-2019 年）的全国代表性估计值，进行了回顾性、横断面研究。确定了患有和不患有 COPD 的成年人（≥18 岁）。无 COPD（对照组）和有 COPD 的成年人按年龄、性别、地理位置和入组年份 5:1 匹配。检查了人口统计学、临床特征、社会经济和一般 HRQoL 指标，包括对 COPD 患者的种族分层分析。
共确定了 4135 名患有 COPD 的患者；匹配数据集代表了一个加权的非机构化人群，其中包括患有 COPD 的 1130 万人和不患有 COPD 的 5420 万人。在患有 COPD 的人群中，66.3%有≥1 种 COPD 相关疾病；62.7%有≥1 种心血管疾病，而不患有 COPD 的患者比例为 33.5%和 50.5%。更多的 COPD 患者失业（56.2%比 45.3%），由于疾病/残疾无法工作（30.1%比 12.1%），有支付账单的问题（16.1%比 8.8%），报告健康状况较差（较差/极差：36.2%比 14.4%），每年因疾病/受伤缺勤天数更多（中位数，2.5 天比 0.0 天），身体功能受限（40.1%比 19.4%）（均<0.0001）。在 COPD 患者的种族分层分析中，自我报告为黑人的患者心血管风险状况更高，社会经济和 HRQoL 结果更差，医疗费用更高，比白人或其他种族的患者更差。
与无 COPD 的成年人相比，患有 COPD 的成年人的临床疾病负担更高，社会经济地位更低，生活质量更差，而黑人群体中患有 COPD 的成年人与白人和其他种族之间的差异更大。了解患者的特征有助于解决护理差异和获取方面的挑战。
