Clinical and economic analysis of antimicrobial therapy of chronic obstructive pulmonary disease exacerbations

Simoens, Steven; Decramer, Marc; Coster, Sandra De; Celis, Geert; Laekeman, Gert

doi:10.1111/j.1742-1241.2006.01240.x

Cited by 14 publications

(10 citation statements)

References 24 publications

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“…Similar to previous studies, economic costs of hospitalisations due to exacerbations were high [6][7][8][9][10]. These findings indicate that the COPD exacerbations requiring hospitalisation have a great impact on healthcare costs.…”

Section: Discussionsupporting

confidence: 88%

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The Cost of COPD Exacerbations Managed in Hospital

Varol¹,

Varol²,

Başer³

et al. 2013

Tur Toraks Der

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AmAç: Kronik Obstrüktif Akciğer Hastalığı (KOAH) belirgin sağlık ve ekonomik sonuçları olan ve sık görülen bir hastalıktır. Bu çalışmada, hastanemizde KOAH alevlenmesine bağlı yatış gerektiren hastaların maliyet analizi yapılmıştır. Gereç ve Yöntemler: Hastanemiz göğüs servisine, bir yıl boyunca, KOAH alevlenmesi nedeniyle yatışı yapılan 376 hastanın direk maliyet analizi değerlendirilmiştir. BulGulAr: Çalışmaya alınan hastaların 311'i erkek, 65 tanesi kadındır. Hastaların median yatış süresi 8 (ortalama: 9.86) gündür ve ortalama yaşı 65.31'dir. Her atak başına düşen ilaç maliyeti 526.55 Türk Lirası (TL) ($392.94, €333.25), hastane bakım maliyeti 1271.94 TL ($949.20, €805.02) ve genel maliyet 1833.8537 TL'dır ($1368.54, €1160.66). Akciğer kanseri ve sekel akciğer tüberkülozu ek hastalığı olan hastalarda hastane yatış süresi istatistiksel olarak daha uzundur. Antibiyotik kullanımı hastane yatış süresini ve maliyeti arttırmıştır. Yoğun bakımda tedavi görülmesi, hastane kökenli enfeksiyon varlığı ve uzun süreli oksijen ihtiyacı maliyeti ve hastane yatış süresini arttırmıştır. Sonuç: Bu çalışmada, hastane yatışı gerektiren KOAH alevlenmelerinde antibiyotik kullanımının, hastane kökenli enfeksiyon varlığının, uzun süreli oksijen tedavisinin ve yoğun bakımda tedavi görülmesinin maliyeti arttırdığı saptanmıştır. AnAhtAr Sözcükler: KOAH, alevlenme, maliyet Geliş Tarihi: 12.02.2011 Kabul Tarihi: 06.09.2011 oBJectIveS: Chronic obstructive pulmonary disease (COPD) is a common disease that has severe health and economic consequences. In this study we estimated the economic cost of COPD exacerbations requiring hospital stay in our hospital. mAterIAl And methodS: The direct cost of 376 hospitalizations during one year with the diagnosis of COPD exacerbations were evaluated retrospectively in our hospital's chest diseases department. reSultS: Three hundred and eleven of the patients enrolled in the study were men while only 65 were women. The mean age of patients was 65.31 and median hospitalization time was 8 (mean: 9.86) days. The average medication cost per exacerbation was 526.55 Turkish Lira (TL) ($392.94, €333.25), the average hospital care cost per exacerbation was 1271.94 TL ($949.20, €805.02) and the average total cost per exacerbation was 1833.8537 TL ($1368.54, €1160.66). The hospitalization time for patients with lung malignancy and sequelae of lung tuberculosis were found to be statistically longer. Antibiotic treatment increased the costs and hospitalization time. Treatment in intensive care units, nosocomial infections and necessity of long term oxygen treatment all increased the costs and hospital stay time.concluSIon: This study shows that the cost of intensive care unit treatment, long term oxygen treatment, treatment of hospital acquried infections and use of antibiotics were higher than usual in COPD exacerbations requiring hospitalisations.

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Section: Discussionsupporting

confidence: 88%

“…Simoens et al [9], using a symptom-based exacerbation definition, followed 267 patients in Belgium and found the median cost of hospital treatment to be €5143 (7757$) per exacerbation. Hospital stay was 75% of the total costs.…”

Section: Discussionmentioning

confidence: 99%

The Cost of COPD Exacerbations Managed in Hospital

Varol¹,

Varol²,

Başer³

et al. 2013

Tur Toraks Der

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“…The literatures reports that the estimated costs for hospitalization due to acute exacerbation will range from $5,655 to $7,413 in developed countries [37][38][39]. The reduced frequency (27.2%) of acute exacerbation in the PV+IV group in this study, compared to the IV group, has significant economic implications for patients with COPD.…”

Section: Discussionmentioning

confidence: 80%

Additive effect of pneumococcal vaccine and influenza vaccine on acute exacerbation in patients with chronic lung disease

Furumoto

Ohkusa

Chen

et al. 2008

Vaccine

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To determine the clinical efficacy of combined vaccination with 23-valent pneumococcal vaccine (PV) and influenza vaccine (IV) against pneumonia and acute exacerbation of chronic lung diseases (CLD), we conducted an open-label, randomized, controlled study among 167 adults with CLD over a 2 year period. Subjects were randomly assigned to a PV+IV group (n=87) or an IV group (n=80), respectively. The number of patients with CLD experiencing infectious acute exacerbation (P=0.022), but not pneumonia (P=0.284), was significantly lower in the PV+IV group compared with the IV group. When these subjects were divided into subgroups, an additive effect of PV with IV in preventing infectious acute exacerbation was significant only in patients with chronic obstructive pulmonary diseases (P=0.037). In patients with CLD, the Kaplan-Meier survival curves demonstrated a significant difference for infectious acute exacerbation (P=0.016) between the two groups. An additive effect of PV with IV on infectious acute exacerbation was found during the first year after vaccination (P=0.019), but not during the second year (P=0.342), and was associated with serotype-specific immune response in sera of these patients who used PV during the same period.

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“…In this study, the total cost of hospitalization due to COPD exacerbations was found to be $808. Previous studies have reported a wide range of cost per hospitalization (between $612 and $9,545) 5–7,19–24…”

Section: Discussionmentioning

confidence: 99%

Clinical factors and comorbidities affecting the cost of hospital-treated COPD

Deniz

Şengül

Aydemir³

et al. 2016

COPD

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PurposeWe aimed to assess the effects of comorbidities on COPD costs and to investigate the relationship between comorbidities and clinical variables.Patients and methodsAll patients hospitalized with a diagnosis of COPD exacerbation between January 1, 2014, and December 31, 2014, at all state hospitals of Aydın province, a city located in the western part of Turkey, were included in this study. The costs examined in the study pertained to medications, laboratory tests, hospital stays, and other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees.ResultsA total of 3,095 patients with 5,237 exacerbations (mean age, 71.9±10.5 years; 2,434 males and 661 females) were evaluated. For 880 of the patients (28.9%), or 3,852 of the exacerbations (73.1%), at least one comorbid disease was recorded. The mean cost of each exacerbation was $808.5±1,586, including $325.1±879.9 (40.7%) for hospital stays, $223.1±1,300.9 (27.6%) for medications, $46.3±49.6 (0.9%) for laboratory expenditures, and $214±1,068 (26.5%) for other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees. The cost of each exacerbation was $1,014.9 in patients with at least one comorbidity, whereas it was $233.6 in patients without comorbidity (P<0.001). Age >65 years, female gender, hospitalization in an intensive care unit, invasive or noninvasive mechanical ventilation, and a long duration of hospitalization were all found to be significant factors in increasing total costs during the exacerbations requiring hospitalization (P<0.05 for all).ConclusionComorbidities have an important role in the total costs of acute exacerbations of COPD. Strategies for the prevention, diagnosis, and effective management of comorbidities would decrease the overall financial burden associated with acute exacerbations of COPD.

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Clinical and economic analysis of antimicrobial therapy of chronic obstructive pulmonary disease exacerbations

Cited by 14 publications

References 24 publications

The Cost of COPD Exacerbations Managed in Hospital

The Cost of COPD Exacerbations Managed in Hospital

Additive effect of pneumococcal vaccine and influenza vaccine on acute exacerbation in patients with chronic lung disease

Clinical factors and comorbidities affecting the cost of hospital-treated COPD

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