Costs of chronic obstructive pulmonary disease in urban areas of China: a cross-sectional study in four cities

Purpose: The economic burden of COPD has not been well studied in China. This study investigated the total costs caused by COPD and the influencing factors for the high economic burden in urban areas of China. Patients and methods: A cross-sectional study was carried out among 678 COPD patients in four cities in China in 2011. The average annual direct medical costs (DMCs), direct nonmedical costs (DNMCs), and indirect costs (ICs) on COPD were measured by median and mean (+/- standard deviation). Logistic regression model was used to explore factors related to high total costs on COPD. Results: The median annual DMCs, DNMCs, and ICs per COPD patient were RMB 5565 Yuan (US$ 862), 0 Yuan (US$ 0), and 0 Yuan (US$ 0), respectively, and the mean annual DMCs, DNMCs, and ICs per COPD patient were RMB 11968 (+/- 22422) Yuan [US$ 1853 (+/- 3472)], 539 (+/- 2092) Yuan [US$ 83 (+/- 324)], and 2087 (+/- 8110) Yuan [US$ 323 (+/- 1256)], respectively. The annual DMCs, DNMCs, and ICs for diagnosed COPD patients were RMB 195.70 billion Yuan (US$ 30.30 billion), 8.78 billion Yuan (US$ 1.36 billion), and 34.10 billion Yuan (US$ 5.28 billion), respectively, in China. Hospitalization accounted for 56.7% of the total costs. High economic burden was significantly related to age, acute exacerbations, and disease severity in COPD patients. Conclusion: COPD posed a heavy economic burden in China. Measures to delay the disease progression and to reduce the risks of acute exacerbation and hospitalization will help substantially lower the costs for COPD care.