<p>Healthcare Service Usage and Costs for Elderly Patients with Obstructive Lung Disease</p>

Abstract

Background The worldwide prevalence of obstructive lung disease (OLD) is increasing, especially among people >65 years old, and nearly three in four adults with OLD have two or more comorbid conditions. This study describes the impact of such comorbidities on the healthcare service usage and related costs in a country with universal health coverage, basing on a large cohort of elderly patients with OLD and employing real-world data. Methods We carried out a retrospective cohort study on a large population of elderly (age >64 years) patients with OLD served by a Local Health Unit in northern Italy. Their comorbidities were assessed using the clinical diagnoses assigned by the Adjusted Clinical Group (ACG) system to individual patients by combining different information flows. Correlations between number of comorbidities and total annual healthcare service usage and costs were examined with Spearman’s test. Regression models were applied to analyze the associations between the above-mentioned variables, adjusting for age and sex. Results All types of healthcare service usage (access to emergency care; number of outpatient visits; number of hospital admissions) and pharmacy costs increased significantly with the number of comorbidities. Average total annual costs increased steadily with the number of comorbidities, ranging from € 1158.84 with no comorbidities up to € 9666.60 with 6 comorbidities or more. Poisson regression analyses showed an independent association between the number of comorbidities and the use of every type of healthcare service. Conclusion These results based on real-world data provide evidence that the burden of care for OLD patients related to their comorbidities is independent of and in addition to the burden related to OLD alone and is strongly dependent on the number of comorbidities, suggesting a holistic approach to multimorbid patients with OLD is the most sound public health strategy.

Recent Prevalence of and Factors Associated With Chronic Obstructive Pulmonary Disease in a Rapidly Aging Society: Korea National Health and Nutrition Examination Survey 2015–2019

“… 41 42 Another problem is that they are often unable to properly communicate with their caregivers. 43 Regarding treatment, poor inhaler technique is also an important issue in elderly patients; studies have shown that there is a negative correlation between advancing age and appropriate inhaler technique regardless of inhaler type. 44 Therefore, constant efforts are needed to overcome those fragile aspects of geriatric phenotype and future studies are also needed regarding this topic.…”

Treatment patterns in essential tremor: Real‐world evidence from a United Kingdom and France primary care database

“…Study results also indicate that a higher number of concomitant therapies and the presence of psychiatric conditions among ET patients were associated with an increased likelihood of receiving [45]. It is well known that patients' expectations as well as patient pressure might result in unnecessary prescriptions, referrals, and investigations [46].…”

“…Study results also indicate that a higher number of concomitant therapies and the presence of psychiatric conditions among ET patients were associated with an increased likelihood of receiving treatments. Patients receiving multiple concomitant medications are in fact likely to be affected by different diseases, which in turn demands a great commitment of healthcare services, including diagnostics, hospital services, and physician visits [45]. It is well known that patients' expectations as well as patient pressure might result in unnecessary prescriptions, referrals, and investigations [46].…”