The burden of chronic obstructive pulmonary disease among employed adults.
The burden of chronic obstructive pulmonary disease among employed adults.
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DOI：
10.2147/copd.s29280
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发表时间：
2012
影响因子：
2.8
通讯作者：
Shah H
中科院分区：
文献类型：
--
作者：
DiBonaventura Md;Paulose-Ram R;Su J;McDonald M;Zou KH;Wagner JS;Shah H
研究美国40-64岁慢性阻塞性肺疾病（COPD）患者的生活质量、工作效率和医疗资源使用情况。数据来自2009年全国健康和健康调查。所有年龄在40-64岁、有或没有自我报告的慢性阻塞性肺病诊断的受雇成年人都被纳入研究。使用回归模型分析对生活质量（使用Short Form-12v2中的精神和身体成分总结得分和健康效用）、工作效率和活动障碍（使用工作效率和活动障碍问卷）以及资源使用的影响。有1112名患有慢性阻塞性肺病的成年雇员与18912名没有慢性阻塞性肺病的成年雇员。在调整了人口统计学和患者特征后，COPD成人报告的精神成分总结（46.8 vs 48.5）、身体成分总结（45.6 vs 49.2）和健康效用（0.71 vs 0.75）的平均水平显著低于非COPD成人。慢性阻塞性肺病患者的出勤率（18.9%比14.3%）、总体工作障碍（20.5%比16.3%）和日常活动障碍（23.5%比17.9%）明显高于无慢性阻塞性肺病的成年人。在过去的6个月里，患有COPD的在职成年人的平均急诊次数（0.21比0.12）和平均住院次数（0.10比0.06）也比没有COPD的在职成年人多。以上差异均有显著性，双侧P < 0.05。在对各种混杂因素进行调整后，患有慢性阻塞性肺病的成年雇员报告的生活质量和工作效率明显低于没有慢性阻塞性肺病的成年雇员，并且卫生保健资源利用率高于没有慢性阻塞性肺病的成年雇员。这些结果突出了慢性阻塞性肺病对美国劳动力的重大影响和负担。
To examine quality of life, work productivity, and health care resource use among employed adults ages 40–64 years with chronic obstructive pulmonary disease (COPD) in the United States. Data from the 2009 National Health and Wellness Survey were used. All employed adults ages 40–64 years with or without a self-reported diagnosis of COPD were included in the study. Impact on quality of life (using the mental and physical component summary scores and health utilities from the Short Form-12v2), work productivity and activity impairment (using the Work Productivity and Activity Impairment questionnaire), and resource use were analyzed using regression modeling. There were 1112 employed adults with COPD versus 18,912 employed adults without COPD. After adjusting for demographics and patient characteristics, adults with COPD reported significantly lower mean levels of mental component summary (46.8 vs 48.5), physical component summary (45.6 vs 49.2), and health utilities (0.71 vs 0.75) than adults without COPD. Workers with COPD reported significantly greater presenteeism (18.9% vs 14.3%), overall work impairment (20.5% vs 16.3%), and impairment in daily activities (23.5% vs 17.9%) than adults without COPD. Employed adults with COPD also reported more mean emergency room visits (0.21 vs 0.12) and more mean hospitalizations (0.10 vs 0.06) in the previous 6 months than employed adults without COPD. All of the above differences were significant at two-sided P < 0.05. After adjusting for various confounders, employed adults with COPD reported significantly lower quality of life and work productivity, and increased health care resource utilization than employed adults without COPD. These results highlight the substantial impact and burden of COPD in the United States workforce.