Economic analysis in admitted patients with acute exacerbation of chronic obstructive pulmonary disease

Chen, Yahong; Yao, Wan-zhen; Cai, Baiqiang; Wang, Hong; Deng, Xiaomei; Gao, Huiping; Huang, Jianguo; Wang, Xin-mao

doi:10.1097/00029330-200804010-00003

Cited by 41 publications

(37 citation statements)

References 9 publications

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“…The elderly generally have a high need for hospitalizations and caregivers partly due to increased risks of comorbidities and poor physical conditions 17. Previous studies had shown the relationship between costs of COPD and acute exacerbation,9,22,23 which was consistent with the results of this study. Acute exacerbation was a major cause of hospitalization 23,24.…”

Section: Discussionsupporting

confidence: 92%

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

Chen

Wang

Chen

et al. 2016

COPD

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PurposeThe 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 methodsA 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.ResultsThe 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.ConclusionCOPD 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.

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Section: Discussionsupporting

confidence: 92%

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

Chen

Wang

Chen

et al. 2016

COPD

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“…A longer hospital duration is also associated with increased daily costs due to treatment-resistant, severe cases with many accompanying comorbidities in addition to increased expenditures for hospital stays. The relationship between increased costs and a lengthy hospital stay has been demonstrated in many studies 6,23,33…”

Section: Discussionmentioning

confidence: 93%

“…This ratio was 3.5 times in our study. In addition, in previous studies, hypertension, cor pulmonale, chronic renal failure, peptic ulcer, liver disease, and apnea were shown to increase the total cost of COPD 6,7,33–35…”

Section: Discussionmentioning

confidence: 93%

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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“…The authors concluded that identifying patients likely to have an unfavorable outcome, reducing the intensity of care for certain types of patients, and reducing costly readmissions should be future priorities to improve the value of prolonged mechanical ventilation [13 ]. The implications of mechanical ventilation and noninvasive ventilation are also evident in an assessment of the economic burden of acute exacerbations of chronic obstructive pulmonary disease conducted at four hospitals in Beijing [14 ].…”

Section: Mechanical Ventilationmentioning

confidence: 99%