title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Health Sciences Practice, Kantar Health, New York, NY 10010, USA. marco.dibonaventura@kantarhealth.com
authors.forename: Marco daCosta
authors.initials: Md
authors.lastname: DiBonaventura
authors.forename: Ryne
authors.initials: R
authors.lastname: Paulose-Ram
authors.forename: Jun
authors.initials: J
authors.lastname: Su
authors.forename: Margaret
authors.initials: M
authors.lastname: McDonald
authors.forename: Kelly H
authors.initials: KH
authors.lastname: Zou
authors.forename: Jan-Samuel
authors.initials: JS
authors.lastname: Wagner
authors.forename: Hemal
authors.initials: H
authors.lastname: Shah
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004526:Efficiency; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004651:Employment; D006295:Health Resources / Q000706:statistics & numerical data*; D006306:Health Surveys; D006760:Hospitalization; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology