The burden of chronic obstructive pulmonary disease among employed adults

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: activities of daily living; chronic obstructive pulmonary disease; health care resource use; quality of life; work productivity.

Figure 1

Inclusion and exclusion flow chart. Note: ^aEligible responders included those who provided informed consent, were aged 18 years and over, and completed the survey instrument. Abbreviations: NHWS, National Health and Wellness Survey; COPD, chronic obstructive pulmonary disease.

Figure 2

Mean levels of quality of life components after adjusting for patient demographic and patient characteristics (comparing workers with COPD versus those without). Note: Differences in MCS and PCS were found to be statistically significant (P < 0.0001). Abbreviations: COPD, chronic obstructive pulmonary disease; MCS, mental component summary score; PCS, physical component summary score.

Figure 3

Mean levels of work productivity and activity impairment after adjusting for demographics and patient characteristics (comparing workers with COPD versus those without). Note: Differences in presenteeism, overall work impairment, and activity impairment were found to be statistically significant (P < 0.0001). Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 4

Mean levels of resource use after adjusting for demographics and patient characteristics (comparing workers with COPD versus those without). Note: Differences in ER visits, hospitalizations, and provider visits were found to be statistically significant (P < 0.0001). Abbreviations: COPD, chronic obstructive pulmonary disease; ER, emergency room.