Disease Burden and Health-Related Quality of Life (HRQoL) of Chronic Obstructive Pulmonary Disease (COPD) in the US – Evidence from the Medical Expenditure Panel Survey (MEPS) from 2016-2019

Figures & data

Table 1 Selected Characteristics by COPD Status Among Adults Aged ≥18 Years and in People Living with COPD Stratified by Race, 2016–2019 (MEPS)^a

Characteristics	COPD					No COPD (N=54,159,701)	P-value (COPD vs no COPD)
	Overall (N=11,288,864)	White (N=9,819,838)	Black (N=883,320)	Other (N=585,705)	P-value (within COPD)
Age in years, mean, (SD)	59.3 (0.5)	59.9 (0.5)	57.6 (1.1)	52.9 (1.6)	0.0001	59.7 (0.2)	0.35
Median	61.0	61.6	58.4	55.4		61.2
Age category, in years, (%)					0.001		0.40
18–34	10.7	10.1	12.3	19.8		9.5
35–44	9.0	9.0	7.8	10.7		8.8
45–54	12.8	12.3	15.8	16.6		13.4
55–64	24.8	24.6	28.6	21.7		25.8
≥65	42.7	44.0	35.4	31.2		42.6
Female (%)	62.1	61.4	69.0	63.9	0.07	62.3	0.90
Geographic region (%)					<0.0001		0.32
Northeast	16.4	17.2	10.3	13.0		17.2
Midwest	24.9	25.6	20.1	20.5		26.6
South	40.6	39.0	60.0	38.8		38.2
West	18.0	18.2	9.6	27.7		18.0
Race/ethnicity (%)							<0.0001
White – no other race reported	87.0	100.0	NA	NA		79.9
Black – no other race reported	7.8	NA	100.0	NA		11.9
Other race – only single race reported	2.1	NA	NA	40.2		6.0
Multiple races reported	3.1	NA	NA	59.8		2.1
Education completed (%)					0.007		<0.0001
4-year college	17.5	17.7	13.1	19.9		22.3
Marital status					<0.0001
Married	49.2	51.3	32.0	38.6		57.8
Widowed/Divorced	34.5	34.4	37.0	32.9		26.8
Sources of health insurance (%)					<0.0001		<0.0001
Private	34.8	35.4	26.7	36.6		42.4
Medicare	51.4	52.1	49.5	42.4		45.1
Medicaid	10.8	9.7	18.3	18.2		7.0
Other	0.6	0.5	1.6	0.7		0.4
Uninsured	2.5	2.3	3.9	2.1		5.1

Notes: ^aAnalyses were conducted on the weighted and matched population with matching performed using age, sex, geographic region, and year of entry.

Abbreviations: COPD, chronic obstructive pulmonary disease; MEPS, Medical Expenditure Panel Survey; SD, standard deviation.

Table 2 Key Concurrent Conditions by COPD Status Among Adults Aged ≥18 Years and in People Living with COPD Stratified by Race, 2016–2019 (MEPS)^a

Key concurrent conditions (%)	COPD					No COPD (N=54,159,701)	P-value (COPD vs no COPD)
	Overall (N=11,288,864)	White (N=9,819,838)	Black (N=883,320)	Other (N=585,705)	P-value (within COPD)
No concurrent conditions	10.1	9.9	11.0	12.3	0.56	26.8	<0.0001
At least 1 COPD-related concurrent condition^b	66.3	66.5	66.1	63.4	0.74	33.5	<0.0001
At least 1 concurrent condition not related to COPD^c	81.5	81.4	84.7	77.5	0.16	67.8	<0.0001
Arthritis	31.0	30.3	39.8	29.1	0.01	17.4	<0.0001
Asthma	29.7	28.5	37.4	38.1	0.002	5.7	<0.0001
Back problems	23.6	23.4	23.9	25.7	0.82	14.4	<0.0001
Cancer	11.1	11.4	9.2	9.3	0.50	8.5	<0.0001
Coronary heart disease	16.7	16.6	18.1	14.7	0.70	7.6	<0.0001
Congestive heart failure	4.1	3.8	7.5	2.8	0.01	1.0	<0.0001
Depression	21.1	21.7	13.9	21.4	0.02	10.6	<0.0001
Diabetes	20.5	20.2	26.0	17.0	0.05	15.2	<0.0001
Dyslipidemia	40.0	39.9	40.7	40.4	0.97	31.2	<0.0001
HIV	0.4	0.1	2.4	1.2	<0.0001	0.2	0.02
Hypertension	49.5	48.3	68.1	40.7	<0.0001	39.7	<0.0001
Injuries	20.3	20.7	15.2	20.5	0.15	13.4	<0.0001
Mental health and/or substance abuse problems	29.0	29.8	21.3	26.5	0.02	14.7	<0.0001
Other heart diseases	9.9	10.3	7.7	6.8	0.16	5.9	<0.0001
Pneumonia	9.8	10.3	7.7	3.9	0.007	1.6	<0.0001
Pregnancies	0.8	0.8	1.0	0.0	0.17	1.1	0.29
Renal failure	1.1	1.0	1.6	2.0	0.25	0.8	0.22
Skin disorders	14.9	15.1	12.7	14.8	0.60	9.5	<0.0001
Stroke	0.3	0.3	0.8	0.0	0.04	0.4	0.51

Notes: ^aAnalyses were conducted on the matched population with matching performed using age, sex, geographic region, and year of entry. ^bConcurrent conditions considered to be COPD-related include asthma, congestive heart failure, coronary heart disease, depression, other mental health and/or substance abuse problems, other heart diseases, pneumonia, and stroke. ^cConcurrent conditions not related to COPD include arthritis, back problems, cancer, diabetes, dyslipidemia, HIV/AIDS, hypertension, injuries, pregnancy, renal failure, and skin disorders.

Abbreviations: COPD, chronic obstructive pulmonary disease; MEPS, Medical Expenditure Panel Survey.

Figure 1 Key cardiovascular concurrent conditions^a by COPD status among adults aged ≥18 years.

Notes: ^a Cardiovascular conditions included coronary heart disease, congestive heart failure, hypertension, dyslipidemia, and other heart disease. ^bAll differences were statistically significant (P<0.0001).

Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 2 Socioeconomic and HRQoL outcomes in people living with COPD and without COPD, 2019 (MEPS).

Note: ^a All differences were statistically significant (P<0.0001).

Abbreviations: COPD, chronic obstructive pulmonary disease; MEPS, Medical Expenditures Survey; HRQoL, health-related quality of life.

Figure 3 Socioeconomic and HRQoL outcomes in people living with COPD stratified by race, 2019 (MEPS).

Notes: ^aThis refers to those who were not employed/unemployed at the time of the MEPS interview. ^b P<0.0001. ^c P<0.001. ^d P<0.05.

Abbreviations: COPD – chronic obstructive pulmonary disease; MEPS – Medical Expenditures Survey; HRQoL – health-related quality of life.

Table 3 Healthcare and Prescription Expenses by COPD Status and in People Living with COPD Stratified by Race, 2016–2019 (MEPS)

Cost variables	COPD (N=11,288,864)					No COPD (N=54,159,701)	P-value (COPD vs no COPD)
	Overall (N=11,288,864)	White (N=9,819,838)	Black (N=883,320)	Other (N=585,705)	P-value (within COPD)
Total healthcare expenses, $^a							<0.0001
Mean (SE)	15,995 (527)	15,726 (545)	18,008 (1661)	17,461 (2627)	0.35	8,739 (170)
Median	7,930	8,066	7,204	6,500		2,861
Total prescription expenses, $^a							<0.0001
Mean (SE)	4,859 (222)	4,713 (241)	5,773 (647)	5,930 (1084)	0.20	2,206 (72)
Median	1,834	1,828	1,941	1,709		283

Notes: ^aAdjusted to 2021 USD based on the Personal Health Care Price Index.³

Abbreviations: COPD, chronic obstructive pulmonary disease; MEPS, Medical Expenditure Panel Survey; SE, standard error; USD, United States dollar.

Figure 4 HCRU outcomes in people living with COPD and without COPD, 2019 (MEPS).

Note: ^a All differences were statistically significant (P<0.0001).

Abbreviations: COPD, chronic obstructive pulmonary disease; ED, emergency department; HCRU, healthcare resource utilization; MEPS, Medical Expenditures Survey.

Figure 5 HCRU outcomes in people living with COPD stratified by race, 2019 (MEPS).

Notes: ^aP<0.0001. ^bP=0.0172.

Abbreviations: COPD, chronic obstructive pulmonary disease; ED, emergency department; HCRU, healthcare resource utilization; MEPS, Medical Expenditures Survey.

Murphy SL, Kochanek KD, Xu J, Arias E. Mortality in the United States, 2020. NCHS Data Brief No. 427; 2021. Available from: https://www.cdc.gov/nchs/products/databriefs/db427.htm. Accessed August 19, 2022.

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