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The clinical and economic impact of exacerbations of chronic obstructive pulmonary disease: a cohort of hospitalized patients.


ABSTRACT:

Background

Chronic Obstructive Pulmonary Disease (COPD) is a common disease with significant health and economic consequences. This study assesses the burden of COPD in the general population, and the influence of exacerbations (E-COPD) on disease progression and costs.

Methods

This is a secondary data analysis of healthcare administrative databases of the region of Lombardy, in northern Italy. The study included ? 40 year-old patients hospitalized for a severe E-COPD (index event) during 2006. Patients were classified in relation to the number and type of E-COPD experienced in a three-year pre-index period. Subjects were followed up until December 31st, 2009, collecting data on healthcare resource use and vital status.

Results

15857 patients were enrolled -9911 males, mean age: 76 years (SD 10). Over a mean follow-up time of 2.4 years (1.36), 81% of patients had at least one E-COPD with an annual rate of 3.2 exacerbations per person-year and an all-cause mortality of 47%. A history of exacerbation influenced the occurrence of new E-COPD and mortality after discharge for an E-COPD. On average, the healthcare system spent 6725€ per year per person (95%CI 6590-6863). Occurrence and type of exacerbations drove the direct healthcare cost. Less than one quarter of patients presented claims for pulmonary function tests.

Conclusions

COPD imposes a substantial burden on healthcare systems, mainly attributable to the type and occurrence of E-COPD, or in other words, to the exacerbator phenotypes. A more tailored approach to the management of COPD patients is required.

SUBMITTER: Blasi F 

PROVIDER: S-EPMC4074190 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

The clinical and economic impact of exacerbations of chronic obstructive pulmonary disease: a cohort of hospitalized patients.

Blasi Francesco F   Cesana Giancarlo G   Conti Sara S   Chiodini Virginio V   Aliberti Stefano S   Fornari Carla C   Mantovani Lorenzo Giovanni LG  

PloS one 20140627 6


<h4>Background</h4>Chronic Obstructive Pulmonary Disease (COPD) is a common disease with significant health and economic consequences. This study assesses the burden of COPD in the general population, and the influence of exacerbations (E-COPD) on disease progression and costs.<h4>Methods</h4>This is a secondary data analysis of healthcare administrative databases of the region of Lombardy, in northern Italy. The study included ≥ 40 year-old patients hospitalized for a severe E-COPD (index event  ...[more]

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