The Humanistic and Economic Burden of COPD Patients in Urban China: A Propensity Score Matching Study

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.

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.

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.

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.