A new study recently published in the journal Health and Quality of Life Outcomes revealed that in China, the quality of life of patients with chronic obstructive pulmonary disease (COPD) is linked to the direct medical costs of the disease. The study was conducted by researchers at Fudan University in China and the University of Ottawa in Canada, and is entitled “Quality of life and its association with direct medical costs for COPD in urban China.” The study, while regionally focused in China, could have implications in improving COPD patient outcomes worldwide.

COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide, and a leading cause of death in the United States. It is a progressive disease in which individuals develop serious breathing problems, including obstruction of the airways, shortness of breath (dyspnea) and acute exacerbations. COPD can seriously impact the patient’s physical capacity, well-being and social functioning. Smoking is considered to be the leading cause of COPD and the disease is known to lead to a high economic burden.

In China, COPD has been estimated to have a prevalence as high as 8.2% in individuals 40 years and older. Although COPD is responsible for a considerable number of deaths, few studies have been conducted regarding the patient’s quality of life (QoL) and associated medical direct costs in China.

In this study, a survey was performed in 2011 involving 678 COPD patients in four main Chinese cities (Beijing, Chengdu, Guangzhou and Shanghai). Data was collected regarding the patient’s health condition, socio-demographic status and medical costs. To evaluate QoL, the team employed the EuroQol (EQ-5D) health questionnaire, a simple standardized tool to assess health outcome.

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Researchers found that almost 40% of the Chinese COPD patients had impaired mobility, pain/discomfort and difficulties in daily activities, resulting in a poorer QoL. One-third of the patients were found to suffer from several degrees of anxiety/depression, and one-fifth experienced difficulties in self-care. The team observed that the patient’s health scores decreased with the severity of the disease. Age, gender and disease severity were found to be significantly associated to the patient’s QoL, and a poorer QoL was a strong indicator of higher medical costs for COPD care.

The team concluded that a poor QoL in COPD patients was related to an increase in medical costs, and proposed that improving QoL could potentially reduce the direct medical costs associated to the disease. The authors also suggest that QoL is a good predictor for medical costs and could be considered a relevant measure for policy- and decision-making in COPD care.