title: Quality of life and its association with direct medical costs for COPD in urban China.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Few studies have focused on the quality of life (QoL) associated medical costs for COPD in China.
  
  
  METHODS
  A cross-sectional survey of 678 COPD patients was conducted in four major cities (Beijing, Shanghai, Guangzhou and Chengdu), China, in 2011. Data on socio-demographic information, health conditions and medical costs were collected through a face-to-face interview combined with medical record searching. The EuroQol (EQ-5D) health questionnaire was applied to assess the QoL of COPD patients.
  
  
  RESULTS
  Among 678 patients with COPD, nearly 40% had difficulties in mobility, usual activities and pain/discomfort, one third had various degrees of anxiety/depression, and one fifth had difficulties in self-care. The COPD patients had a median utility score of 0.768 and a median visual analog scale score of 70. The degree of difficulties in any dimensions significantly increased, and utility and health scores decreased with severity of the disease. Age, gender and disease severity were significantly associated with the quality of life after taking other covariates into consideration. Poorer QoL was a significant indicator of higher direct medical costs for COPD patients.
  
  
  CONCLUSIONS
  Impaired quality of life was significantly linked to increased medical costs for COPD patients and could be an important measure for policy- and decision-making in COPD care.
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China. mmwu@fudan.edu.cn.
authors.forename: Minmin
authors.initials: M
authors.lastname: Wu
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China. zhaoqi@shmu.edu.cn.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. Yue.Chen@uottawa.ca.
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China. cwfu@shmu.edu.cn.
authors.forename: Chaowei
authors.initials: C
authors.lastname: Fu
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China. bxu@shmu.edu.cn.
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing; D002681:China; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000628:therapy*; D011788:Quality of Life; D012648:Self Care / Q000706:statistics & numerical data*; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*