Lei Dou,1– 4 Yu Zheng,5 Junchao Feng,1– 4 Zhezhou Huang,6 Fei Qin,6 Mingyue Gao,6 Shunping Li1– 4 

1Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China; 2NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, People’s Republic of China; 3Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, Shandong, People’s Republic of China; 4Center for Health Preference Research, Shandong University, Jinan, Shandong, People’s Republic of China; 5Blood Center of Shandong Province, Jinan, Shandong, People’s Republic of China; 6Cerner Enviza, Shanghai, People’s Republic of China

Correspondence: Shunping Li, Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road44, Jinan, Shandong, 250012, People’s Republic of China, Email lishunping@sdu.edu.cn

Purpose: Chronic obstructive pulmonary disease (COPD) is a leading cause of death in China. However, few national surveys have comprehensively evaluated the health and economic outcomes among COPD patients in China. The objective of this study was to examine and compare the humanistic and economic burden of COPD patients with a control group.
Patients and Methods: Data from the 2020 National Health and Wellness Survey (NHWS) in China (N=20051), a nationally representative survey targeting urban adults, was used in this study. The propensity score matching (PSM) method was employed to match respondents who reported being diagnosed with COPD by a physician with those who did not have COPD. Differences between COPD patients and matched controls were assessed in terms of quality of life (using EQ-5D-5L and SF-12v2), work productivity loss, healthcare resource utilization over the past 6 months, and estimated annual indirect costs.
Results: COPD patients exhibited significantly worse outcomes compared to non-COPD respondents. The mean scores for MCS, PCS, and health state utility (HSU) were substantially lower in COPD patients than in the control group (47.69 vs 49.49, 47.27 vs 51.71, and 0.90 vs 0.94, respectively; all P < 0.01). Moreover, the score difference between COPD patients and the control group reached minimal clinically important difference (MCID) for both PCS and HSU. Compared to the non-COPD population, COPD patients reported higher rates of absenteeism (6.88% vs 3.74%, P< 0.01), presenteeism (28.02% vs 21.43%, P< 0.01), work productivity loss (31.31% vs 23.57%, P< 0.01) and activity impairment (27.15% vs 19.53%, P< 0.01), resulting in greater indirect cost. The number of hospitalizations was significantly higher among COPD patients than the non-COPD population (2.11 vs 1.96, P< 0.01), while the number of outpatient visits was similar to that of the control group.
Conclusion: These findings highlight the pervasive impact of COPD on health outcomes. The results highlight the substantial burden of COPD compared with the non-COPD population, suggesting that increased attention and targeted interventions are warranted to address the significant health and economic challenges posed by this disease.

Keywords: chronic obstructive pulmonary disease, health-related quality of life, healthcare resource use, work productivity loss, disease costs