Qt's packaged installer for OSX scatters things throughout the /Developer and /Library directories rather than installing to a self-contained location in /usr/local or /opt/local as you might expect it to do on other unix-based systems.
Incidentally, Qt follows Apple's way of doing things in this respect, so it's really not wrong -- it's just different -- but it does make some 3rd party Qt applications somewhat difficult to build on OSX.
The packaged Qt installer itself has the following to say on this topic:
  After a successful install, you can find most new things in /Developer. Specifically things will be located in the following places:
  
  
  - Qt Designer, Qt Linguist: /Developer/Applications/Qt
- Qt Documentation: /Developer/Documentation/Qt
- Qt Examples: /Developer/Examples/Qt
- Qt Plugins: /Developer/Applications/Qt/Plugins
- Qt Frameworks: /Library/Frameworks
- Qt Libraries: /usr/lib
- qmake, moc, uic, etc.: /Developer/Tools/Qt (symlink to /usr/bin)
- Uninstall script: /Developer/Tools/uninstall-qt.py
So, it does put the libs into '/usr/lib', and it symlinks the essential Qt tools (like qmake) into '/usr/bin'.  This suggests that QTDIR could be set to '/usr'.  In practice however, this doesn't work because the qt headers remain buried in '/Library/Frameworks/Qt*/Headers/*.h', while builds that rely on $QTDIR will end up looking for the qt headers in "${QTDIR}/include/" instead.
The easiest way around all this is to build Qt from source.  The install location will default to something like /usr/local/Trolltech/Qt-4.6.3 (note the version number, and adjust accordingly).  You can override the default install location by using the -prefix option on ./configure.
A simpler approach is to let macports build it for you.  This is the approach I ended up taking (and with good success).  Just install macports, if you don't already have it. Then:
> sudo port selfupdate
> sudo port install qt4-mac
Macports will work its magic, and when it's done Qt will be installed, in its entirety, at /opt/local/libexec/qt4-mac.
Regardless of how you build Qt, expect a full build to take several hours.  It's a very large code base.