Rural-urban disparities in quality of life among patients with COPD

Bradford E. Jackson, David B. Coultas, Sumihiro Suzuki, Karan P. Singh, Sejong Bae

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: Limited evidence in the United States suggests that among patients with chronic obstructive pulmonary disease (COPD), rural residence is associated with higher hospitalization rates and increased mortality. However, little is known about the reasons for these disparities. This study's purpose was to describe the health status of rural versus urban residence among patients with COPD and to examine factors associated with differences between these 2 locations. Methods: This was a cross-sectional study of baseline data from a representative sample of patients with COPD enrolled in a clinical trial. Rural-urban residence was determined from ZIP code. Health status was measured using the SF-12 and health care utilization. Independent sample t-tests, chi-square tests, and multiple linear and logistic regressions were performed to examine differences between rural and urban patients. Findings: Rural residence was associated with poorer health status and higher health care utilization. Among rural patients unadjusted physical functioning scores were lower on the SF-12 (30.22 vs 33.49; P = .005) that persisted after adjustment for potential confounders (β = -2.35; P = .04). However, after further adjustment for social and psychological factors only the body-mass index, airflow obstruction, dyspnea, and exercise (BODE) index was significantly associated with health status. Conclusions: In this representative sample of patients with COPD rural residence was associated with worse health status, primarily associated with greater impairment as measured by BODE index. While rural patients reported a higher dose of smoking, a number of other unmeasured factors associated with rural residence may contribute to these disparities.

Original languageEnglish
JournalJournal of Rural Health
Volume29
Issue numberSUPPL.1
DOIs
StatePublished - 26 Feb 2013

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Chronic Obstructive Pulmonary Disease
Health Status
Quality of Life
Patient Acceptance of Health Care
Patient Advocacy
Social Adjustment
Chi-Square Distribution
Dyspnea
Linear Models
Hospitalization
Body Mass Index
Cross-Sectional Studies
Logistic Models
Smoking
Clinical Trials
Exercise
Psychology
Mortality

Keywords

  • COPD
  • Health disparities
  • Health-related quality of life
  • Rural
  • Utilization of health services

Cite this

Jackson, Bradford E. ; Coultas, David B. ; Suzuki, Sumihiro ; Singh, Karan P. ; Bae, Sejong. / Rural-urban disparities in quality of life among patients with COPD. In: Journal of Rural Health. 2013 ; Vol. 29, No. SUPPL.1.
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Rural-urban disparities in quality of life among patients with COPD. / Jackson, Bradford E.; Coultas, David B.; Suzuki, Sumihiro; Singh, Karan P.; Bae, Sejong.

In: Journal of Rural Health, Vol. 29, No. SUPPL.1, 26.02.2013.

Research output: Contribution to journalArticle

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